Single-payer schemes and proposals to incrementally give government more control and power over health care spending and decisions would harm access and erode quality. Policy initiatives that promote competition, and encourage investment in new drugs, treatments and innovative solutions for delivering health care are the type of reforms that will make the system more responsive to America’s health care consumers.

KERRIGAN IN THE WASHINGTON TIMES: “Government Does Not Know Best When it Comes to Health Care”

August 3rd, 2021 by

In a July 28 Washington Times Op-Ed, SBE Council president & CEO Karen Kerrigan writes that federal government policy is moving in a direction that is not supported, or helpful to, small businesses. She points to a recent Morning Consult survey sponsored by SBE Council that reveals key findings:

Unfortunately, the solutions being advocated and advanced by Washington are totally misaligned with what small businesses need. Leading healthcare bills gaining traction in Congress are pushing for more government intervention and control while small business owners want the opposite, according to a new Morning Consult survey conducted by our organization.

Not surprisingly, according to the survey, small business owners want what’s best for their employees, which is a key reason why they provide health coverage. When asked to identify the biggest benefit of offering health insurance, helping employees stay healthy and productive tops the list (58%) followed by efforts to support recruitment and retainment.

Furthermore, small business owners believe that government does not know best when it comes to health care: 72% of small business owners agree that employers and employees, not the government, should decide which health plan to offer workers.

She concludes by urging the Biden Administration and Congress to do a big pivot on health care, just like small business owners were forced to do with regard to their businesses during the pandemic:

Small business owners and their employees were forced to massively shift their thinking and operations during the pandemic. It’s time for Congress and the federal government to do the same by moving away from the interventionist approach on health care. Instead of mandates, small businesses need incentives and innovation. Instead of behind-the-scenes price negotiations, small businesses need transparency. If Congress wants to get health care reform right, they need to listen to our nation’s small business owners.

Read the full Op-ed here.


Latest GWB Podcast: SBE Council’s Morning Consult Survey on Health Care Policy

July 7th, 2021 by

In this week’s Growth Without Barriers podcast, SBE Council president & CEO Karen Kerrigan discusses why it is important for Congress and the Biden Administration to listen to small business owners on health care policy. According to a new Morning Consult survey sponsored by SBE Council, small business owners want freedom and flexibility, they want more choices, they want transparency across the health care system, and 72% say employers and employees – not government – should choose health plans.

You can access the survey results here, and listen to the highlights in the latest Growth Without Barriers podcast:


Read SBE Council’s LETTER TO CONGRESS on What Small Employers Want in Health Care Policy.

Letter to Congress on Health Care Policy: What Do Small Business Employers Want?

July 1st, 2021 by

Dear Member of Congress:

Rising healthcare costs and limited options are hurting small businesses and their employees. A new survey released this week by SBE Council finds that small business owners want policies that support their efforts to offer more health insurance options, not government intrusions that could undermine those efforts.

In our survey of more than 500 small businesses, conducted by Morning Consult from June 7-17, 72% of small business owners agreed that employers and employees, not government, should decide the type of health plans offered to workers.

Small business owners want to offer employees more choices, but currently they cannot. As Congress continues to explore and propose healthcare and drug pricing legislation, we thought it was important that Members understand the perspective of small business employers. Some of the key takeaways from the survey include:

● More than half (55%) of small business owners cite high costs of health insurance as a barrier to offering health insurance benefits.

● The majority of small business owners agree that employer health care solutions available to them have not kept up with the changing times.

● More than four in five Democrat small business owners (87%) and Republican small business owners (84%) agree employers need diverse health insurance options to meet growing employee needs.

● The majority of small business owners favor price transparency from health insurers and hospitals so that they can plan ahead and avoid surprise medical bills.

● Small business owners are least supportive of allowing the federal government to determine the price of prescription drugs or which prescription drugs are covered in Medicare, among all of the potential policies for lawmakers to consider in addressing healthcare costs.

● More than three quarters of small business leaders favor tax credits and financial incentives, for both businesses and individuals, as opposed to the top-down, anti-free market price controls being debated in Congress now.

This striking data shows that there is a disconnect between some lawmakers, and the voters they represent. As you well know, rising healthcare costs have been a long-term pain point for small businesses. High costs continue to hurt small businesses, and they are hard-pressed to find affordable and relevant health care benefit packages that meet their employees’ needs.

Small business owners want price transparency, minimal government intervention and financial support or incentives when it comes to supporting their efforts to provide health care options for employees.

Watch the Webinar for Insight: SBE Council held a webinar on June 30 to share the findings of the survey with stakeholders in the industry. You can watch the webinar here. In addition, the media release to our survey can be accessed here.

Small businesses and entrepreneurs represent the best of the American Dream, and our members continue to innovate and look forward to a full recovery from the COVID-19 economic nightmare. Being able to recover fully and provide employees (and future employees) with the health coverage they deserve requires a fundamental shift in approach from the federal government. Instead of mandates, we need incentives and innovation. Instead of behind-the-scenes price negotiations, we need transparency.

Thank you for taking the time to hear our concerns and for championing small business during the course of the pandemic. Please let us know if we can provide any additional information regarding the survey or our policy solutions that will help small businesses better recover, compete and grow.


Karen Kerrigan
President & CEO

NEW SURVEY: Small Businesses Overwhelmingly Support a Shift in Federal Healthcare Policy to Improve Access and Coverage Options for Employees

June 30th, 2021 by

“72% agree that employers and employees, not government, should decide the type of health plans offered to workers.”

For Immediate Release
June 30, 2021

Washington, D.C. – Rising health care costs and limited options are hurting small businesses and their employees, the Small Business & Entrepreneurship Council (SBE Council) revealed today. A new survey released by SBE Council finds that small business owners desire policies that support employers’ ability to offer more health insurance options – not government intervention that restricts options – to address issues with health insurance coverage.

The survey, conducted by Morning Consult, revealed that 72% of small business owners agree that employers and employees, not the government, should decide the type of health plans offered to workers.

According to the survey:

●  Rising health care costs are hurting small businesses and their employees. More than half (55%) of small business leaders cite high costs of health insurance as a barrier to offering health insurance benefits.

●  Small businesses seem challenged to find relevant health care benefit packages. Only 1 in 5 (17%) small business leaders strongly agree that the employer health care solutions available to them have kept up with the changing times.

“These survey results point to a Washington bureaucracy that is out of touch with the backbone of the U.S. economy – small businesses,” said SBE Council President & CEO Karen Kerrigan. “As the COVID-19 pandemic winds down and our economy ramps up for what should be a historic recovery, small businesses continue to struggle with a healthcare landscape that undermines their ability to choose health insurance plans that work for them. Additionally, unnecessary barriers in the form of costs and limited support remain in place, dragging down hiring power and hindering recovery and the revenue boost these companies are depending on.

“Small business owners want to get employees back to work and are prioritizing their health and safety. This means providing health insurance options that match the needs of their workforce. Unfortunately, the barriers to providing coverage have persisted for quite some time and continue to this day, as a large portion of the small business community reports the high cost of benefits, annual and unpredictable increases in health insurance costs, and limited buying power as hurdles that prevent them from maximizing health care offerings for employees.”

According to the survey, small business owners are highly dedicated to their employees’ health. When asked to identify the biggest benefits of offering health insurance benefits, the well-being of employees tops the list, followed by competitiveness issues:

●  58% say to maintain employee health and productivity

●  52% say to retain employees, and 51% say to attract employees

●  41% say to improve employee morale

●  Four in five small business owners agree that giving workers access to flexible and affordable options is business critical (79%) and that employers need diverse health insurance options to meet employee needs (81%).

Small businesses are united in their view that the private sector is best equipped to manage health care for their employees. The survey also revealed:

●  87% of small business owners favor requiring health insurance companies to be more transparent about what is covered and what patients will pay out of pocket.

●  87% also favor requiring hospitals to be more transparent about their costs so that patients can plan ahead and aren’t bankrupted by surprise bills.

● Similarly, more than three quarters favor tax credits and financial incentives, for both businesses and individuals, as opposed to the top-down, anti-free market price controls being negotiated in Congress now.

Small business owners are least supportive of allowing the federal government to determine the price of prescription drugs or which prescription drugs are covered in Medicare, among all of the potential policies for lawmakers to address healthcare costs.

Kerrigan added:

“Most businesses believe they would be more effective in managing the costs of employee health coverage if given more options that a nimble private market could provide. This is especially critical, as both the market and employee needs regularly evolve. Unfortunately, over-meddling by government has layered friction and inefficiencies throughout the healthcare system.

“Especially now as they work to recover from the COVID economy, small businesses need a shift in policy. Instead of mandates and more red tape, financial incentives and innovative choices are needed. Small business owners want transparency, flexibility, and innovation. But right now, Washington policies will yield just the opposite. If small businesses are to fully participate in the anticipated recovery boom, healthcare policy must free the private sector and put small businesses and their workers first.”

BRIEFING ON THE SURVEY: SBE Council is hosting a briefing “What Do Employers Want in Health Care” at 3:00 p.m. today (June 30) to discuss more findings and more details within the survey. For more information, or to register, click here.


Karen Kerrigan,
Raymond J. Keating,  

SBE Council is nonpartisan advocacy, research and education organization dedicated to protecting small business and promoting entrepreneurship. For 25 years, SBE Council has worked on and advanced a range of private sector and public policy initiatives to strengthen the ecosystem for strong startup activity and small business growth.

Visit for additional information. Twitter: @SBECouncil


EVENT: What do Employers Want in Health Care? June 30, 3:00 p.m. ET

June 28th, 2021 by

Webinar: What do Employers Want in Health Care?

Join Us on Wednesday, June 30 at 3:00 PM EST to Find Out!

For more than a decade, health reform has focused on the Affordable Care Act, the individual health insurance market, and government program expansion.

● Congress is considering several policies to address health coverage and costs, including a public option, lowering the Medicare age of eligibility, a Medicare buy in, enhanced ACA subsidies, prescription drug pricing reforms, and pay for value schemes.

● Missing from the discussion is what can be done to improve job-based coverage, where more than half the population, or about 180 million people, receive their health coverage.

Please join us on June 30th at 3:00 PM EST for a virtual discussion of new polling results released by the Small Business & Entrepreneurship Council (SBEC) on the health concerns of small business owners and what Congress and the Administration might do about it.

WHAT:                      Discussion on Employer Health Concerns and release of polling results

WHEN:                      June 30, 3 pm Eastern

WHERE:                   Virtual – register here


Karen Kerrigan, President & CEO, Small Business Entrepreneurship Council 

Joel White, President, Council for Affordable Health Coverage 

Small Business Employer Deborah Pittorino, Founder, Greenporter Hotel and the Agrocouncil, Greenport, New York

Please register in advance here.


Kerrigan in the International Business Times: Vaccines are Saving Small Business

April 5th, 2021 by

In an April 4 Op-ed in the International Business Times, SBE Council president & CEO Karen Kerrigan provides a snapshot on the current state of small business, and how vaccines are playing a critical role in driving momentum for economic recovery on Main Street. In the piece, she notes the importance of sound policies that have allowed the COVID-19 vaccines to come to market very rapidly and the need for our elected leaders to understand these policies to make the right choices for the future. Kerrigan lists three key policy pillars in the Op-ed:

One is the 1980 Bayh-Dole Act. It promotes technology transfer from academia to the private sector by letting universities own and license patents on discoveries made with help from federal grants. Prior to the law, the government retained the patents on any innovative ideas that arose from federally funded research. By giving universities the right, and incentive, to license their researchers’ discoveries to private companies, the law has spurred the creation of countless startups.

Another important tenet is allowing companies to price products without government restrictions, which encourages risk-taking and the sizable level of investment it takes to bring a drug or treatment to market.

Finally, stringent protections on intellectual property, including patents, give investors and innovators the confidence they need to make large bets — in terms of financial investment and human capital — on long-shot drug research.

She argues that efforts aimed at weakening IP protections and imposing price controls are terribly misguided: “If we torpedo our current system, the lockdowns we face when the next pandemic rolls around could last much longer.”

Read the full piece here.



Kerrigan and Talento: Ending Surprise Billing Protects Patients and Honesty in Health Care

August 15th, 2019 by

In an August 15 Morning Consult Op-ed, SBE Council president & CEO Karen Kerrigan and health care expert and consultant Katy Talento, who formerly served as the top health policy advisor to President Donald J. Trump on the Domestic Policy Council, wrote about the ills of  “surprise medical billing” and what needs to be done to bring market discipline to this shady business model.  Federally mandated binding arbitration is not one of the “reforms” to resolve the issue, writes Kerrigan and Talento:

“Arbitration would involve a mediator who fixes the price, based on the sky-high, secret rates that some doctors are currently enjoying.

“This is why most conservatives and business groups, along with the Trump Administration, reject federally mandated arbitration outright. Some conservatives, however, have argued that any attempt to rein in price-gouging in these situations constitutes government price controls and moves us closer to a single payer health care system.

“That’s nonsense. In fact, if we fail to appropriately address issues like surprise billing – which is a failure of the market made possibly only by hiding price and network status information from consumers– then we give single payer advocates an effective talking-point against the private system.”

Read the full op-ed here.


Binding Arbitration: A Non-Starter that Won’t Resolve Surprise Billing

August 12th, 2019 by

What they are saying…

Updated November 20, 2019

The last thing a patient needs after getting hit by a surprise medical bill is to endure a complex federally-established “arbitration” process to settle the dispute.  The idea is being advocated by some – largely hospitals and specialty physicians – to include an arbitration scheme in legislation moving through Congress to address the shady practice of surprise billing.  The business community is largely opposed to binding arbitration, and leading free-market health experts feel the same way.

Here’s why, and what they are saying about arbitration as a “solution” to surprise billing:

Encourages the rapid growth of costs

“Specifically, we are concerned about proposals for open-ended arbitration, which have been floated as a solution to the problem. If arbitration appears innocuous, it is to a large extent because it is not transparent. Experience suggests that arbitration would be cumbersome to deploy, and highly favorable to those health care providers who charge high prices today. If Congress were to endorse arbitration, it could potentially open the door to a system quite unintended – establishing an inflationary dynamic that accommodates and encourages the rapid growth of costs.”

Health Care Policy Experts Oppose Open-Ended Arbitration as a Solution to Surprise Billing, Joint Statement, June 25, 2019.


Binding Arbitration Will Cost Taxpayers $6.2 Billion and Employers Providing Coverage $21 Billion

“The independent analysis by CAHC Chief Economist and Congressional Budget Office (CBO) alumnus Jeff Lemieux found that binding arbitration would place an additional $6.2 billion in added costs to the federal budget, and $21 billion in total costs on employers and private payers.  Because employers and insurers pass these added costs onto consumers in the form of increased premiums or cost sharing, patients will end up paying more as a result of binding arbitration versus a pure benchmark model. Experience from the New York arbitration process confirms this will increase private payer costs both as a result of the higher payment rates and greater administrative costs.”

New CAHC Estimate: Binding Arbitration Costs Taxpayers Additional $6.2 Billion, Employer Provided Coverage $21 Billion Over Ten Years, CAHC, November 13, 2019.


Patients don’t have agents like professional baseball players

“Politicians call this [arbitration] a ‘baseball-style’ approach to addressing surprise bills, but those impacted by this policy are not professional baseball players negotiating multimillion-dollar contracts. They are patients caught in a crossfire between health systems and lawyers – and they deserve our best effort to right this wrong…The White House has already signaled its opposition to binding arbitration and the Senate HELP Committee has passed strong, bipartisan legislation that mirrors the Energy and Commerce Committee’s original, commonsense benchmark approach to resolving disputed claims.”

Coalition for Affordable Health Coverage President Joel White, Statement on the addition of binding arbitration amendment to House surprise billing legislation, July 17, 2019.


Binding Arbitration is Making Health Care “Substantially More Expensive”

“According to an analysis of newly released data from New York’s Department of Financial Services, the New York model [‘independent dispute resolution’] is making health care substantially more expensive in the state. In fact, arbiters are typically deciding on dollar amounts above the 80th percentile of typical costs.”

To End Surprise Medical Bills, New York Tried Arbitration. Costs Went Up., NPR, November 5, 2019. Read the USC-Brookings Schaeffer on Health Policy Report here.


Not “simple and easy,” as being billed by proponents

“Policymakers should not be fooled. Arbitration is neither ‘light touch’ nor a solution to the true problem at hand. Instead of solving the fundamental issue, it kicks the can down the road to an arbitrator who faces the same challenges of any rate setter…. arbitration is just rate-setting in another guise — and the arbitrator faces the same challenges of any rate setter. Even the most knowledgeable rate setter would find it difficult to come up with a ‘missing price’ that closely approximates the true market price. And, whether rates are set too high or too low, rate setting can introduce large market distortions and unintended consequences.”

Arbitration Not the Answer to Fix Surprise Medical Billing, Real Clear Policy Op-ed by David Hyman, professor of law at Georgetown University and adjunct scholar at the Cato Institute, and Benedic Ippolito, a research fellow at the American Enterprise Institute, February 12, 2019.


A complex and murky process

“Arbitration is a highly inappropriate and misguided fix to surprise billing…The last thing health care consumers need is a complex, obscure and drawn-out process when it comes to resolving a surprise bill. Moreover, we need to lower costs and bring market forces to bear on the cruel practice of surprise billing, not make matters worse.

“The few players in the health care system who are engaged in the business model of surprise billing are allowed to operate without the benefit of competition. There is no financial accountability to patients or payers. The practice is not subject to the usual market forces of transparency and competition because it proliferates primarily in areas where consumers and insurers have little visibility and even less choice – in the emergency room and an on the operating table.”

Small Business & Entrepreneurship Council Letter to House Energy and Commerce Committee, July 10, 2019.


A step in the wrong direction that adds more costs

“Binding arbitration is an inefficient and ineffective approach to addressing surprise billing and should not be included as a legislative solution. As the committee seeks to bring greater transparency to health care prices, a costly, complex and opaque arbitration process is a step in the wrong direction…this approach is time and resource-consuming and would lead to rates much closer to unreasonably high provider charges such as those cited above that are not bound by market discipline.”

The National Business Group on Health, Statement for the Record, House Ways and Means Health Subcommittee Hearing on “Protecting Patients from Surprise Medical Bills,” May 21, 2019.


Undermines the key goals of lowering costs and protecting patients

“We applaud you for seeking a solution to surprise medical billing in your draft legislation, the ‘Lower Health Care Costs Act.’ Reflecting the goal of employers to protect patients from surprise medical bills without undermining network participation or resulting in higher health care costs for all consumers, we urge you to reject independent dispute resolution (Option 2) as a means of resolving surprise medical billing.”

Employer Community Coalition Letter to Chairman Lamar Alexander (R-TN) and Patty Murray (D-WA), Senate Committee on Health, Education and Labor on “Solutions to Surprise Billing,” June 5, 2019.

SBE Council has joined employer groups in support of a benchmark rate that is determined based on the average of local in-network market-based rates. We believe this is a fair and simple solution that addresses the few players who are exploiting what are effectively loopholes in the way doctors and hospitals bill for services.


Small Business Advocate Applauds Movement on Positive Health Care Reforms, and Today’s Court Decision on Short-Term Transitional Plans

July 19th, 2019 by


For Immediate Release

…Urges Action on the “HIT” and Expresses Unease About “Arbitration” to Surprise Billing, and Certain Drug Price Proposals

Washington, D.C.  – It was a big week for health care reform. The Trump Administration announced another positive initiative for patients and small businesses, and the U.S. House advanced a package of reforms addressing numerous issues related to high costs and transparency. Small Business & Entrepreneurship Council (SBE Council) president & CEO Karen Kerrigan said the focus on health care has generally been good news for entrepreneurs and small businesses, but the group is keeping a close eye on key issues that could raise costs and undermine innovation on life-saving drugs.

“Health coverage costs and access to care remain big concerns for entrepreneurs and small businesses, and it is positive to see both the Trump Administration and Congress advancing sensible changes and reforms that address key problems. At the same time, we are watching a few things that would prove to be counterproductive, but we remain hopeful that lawmakers and regulators will continue to consider our concerns,” said Kerrigan.

In positive news, the Trump Administration announced new guidance on health savings accounts (HSAs), which will help patients better manage chronic conditions, provide more affordable access to treatments, and in the end prevent these conditions from worsening. This first action stemming from Executive Order 13877 (“Improving Price and Quality Transparency in American Healthcare to Put Patients First”) expands the list of preventative care benefits permitted to be provided by a high deductible plan, which will allow patients with chronic conditions such as diabetes, heart disease and asthma to use their HSA dollars to pay for treatment and care before they meet their deductible. This change is effective immediately.

“This important change will allow patients with chronic conditions to manage their health and costs more effectively. We applaud the Administration for listening to patients and the business community,” said Kerrigan.

Legality of Changes to Short-Term Plans Upheld

This latest action on HSAs by the Trump Administration follows a June 14 announcement that expanded and improved health reimbursement accounts (HRAs). These changes will be particularly helpful for small businesses. In August of last year, the Administration also made important changes to short-term plans, and on July 19, a judge ruled that the Trump Administration’s changes were legal and had the authority to do so. Specifically, the final rule lengthened the use of short-term, limited-duration plans from Obamacare’s three-month limit to up to three years, as improved by the Trump Administration rule.

According to The Hill, U.S. District Judge Richard Leon said, “Not only is any potential negative impact from the 2018 rule minimal, but its benefits are undeniable.”

SBE Council fully agrees.

“The judge’s ruling is good news for people who want to start businesses, but need affordable transitional coverage in order to take that risk. It is good news for people who need to leave the workforce for personal or family reasons, but need affordable coverage for longer than the restrictive and impractical three-month limit set by Obamacare,” observed Kerrigan.

Caddy Tax Repealed by U.S. House   

Also, this past week, the U.S. House passed H.R. 748, the “Middle Class Health Benefits Tax Repeal Act of 2019” by a vote of 419-6. The legislation fully repeals the “Cadillac Tax.” The U.S. Senate is expected to act on the legislation soon.  SBE Council has been working with a coalition of business groups in support of repeal and recently signed a letter urging action on the legislation. Over time, the 40% tax is expected to hit all plans, which will put health insurance out of reach for many more small businesses and the self-employed.

“Partially due to taxes and the threat of impending taxes, health coverage costs have increased and access to health care has become more expensive. Repealing this tax is important, and we are pleased to see the massive bipartisan vote in support of ending it for good.  Similarly, it is now time for Congress to repeal or extend the current moratorium on another tax – the Health Insurance Tax (HIT) – which specifically targets small business plans,” said Kerrigan.

Action on the HIT is Long Overdue

Bipartisan bills have been introduced in the Senate and House that would provide relief for small businesses from the unfair and costly HIT, a $50 million per-day tax that directly targets the plans of small businesses and individual entrepreneurs. The legislation, S. 172 and H.R. 1398, the Health Insurance Tax Relief Act of 2019, would extend the current moratorium on the HIT into 2020 and 2021. Small businesses could save on average $196 per individual and $479 per family, which is significant savings, especially for those with multiple employees.

“The extra cost imposed on the health insurance plans of small businesses because of the HIT cannot be forgotten by Congress, and that is why the House and Senate need to address it right away. If it makes sense to repeal the Cadillac Tax it makes equal or even more sense to repeal or extend the current moratorium on the HIT,” added Kerrigan.

House Moves “Surprise Billing” Legislation  

The House Energy and Commerce voted out a package of bills this week, including the “No Surprises Act.” One surprise was the addition of an “arbitration” amendment into the legislation, which will add complexity, obscurity and costs into the process of the resolving surprise bills.  SBE Council president & CEO Karen Kerrigan joined health care experts on June 25 to voice concern about this approach, as well as in a July 10 letter to Energy and Commerce Committee members. Senate legislation does not include the arbitration language, the White House opposes the approach, and SBE Council will work to keep this bad idea out of any final legislation.

Some Proposed “Solutions” to Drug Costs Will Hurt Innovation

In other areas, SBE Council continues to express concern about the proposed International Pricing Index (IPI) for drugs by the Department of Health and Human Services (HHS), which would bring foreign price controls to the United States. (See SBE Council’s comments on the issue here.)  Over in the Senate, some traction is building on a proposal in the Senate Finance Committee that would impose a financial penalty for Medicare Part D on drug manufacturers if their price increases are greater than inflation.

“This is a government rate control proposal, plain and simple. We have to ask the question: Where would this type of government intervention end? Medicare Part D already includes price increase protections, and the system is working,” said Kerrigan.


Karen Kerrigan


SBE Council is nonpartisan advocacy, research and education organization dedicated to protecting small business and promoting entrepreneurship. For 25 years, SBE Council has worked on and advanced a range of private sector and public policy initiatives to strengthen the ecosystem for strong startup activity and small business growth. Visit for additional information. Twitter: @SBECouncil



Joint Statement: Health Policy Experts Discourage Open-Ended Arbitration as Solution to Surprise Billing

June 25th, 2019 by

WASHINGTON – This week the U.S. Senate Committee on Health, Education, Labor, and Pensions is expected to mark-up the “Lower Health Care Costs Act” (S. 1895), which among other things, attempts to address the problem of surprise medical bills.

As members of Congress on both sides of the aisle propose ways to tackle the surprise billing issue, 28* health policy experts released the following joint statement today to voice concern about the use of “open-ended arbitration” as a solution to the problem. A full list of signatories is below.

“We appreciate that both the House and the Senate are addressing the problem of surprise medical bills in a constructive and bipartisan way. Yet, this is not the first time that Congress has attempted to protect individuals from the problem, and so it is important to ensure that reforms enacted achieve their intended purpose, and do not merely add more cost and complexity to American healthcare.

“Specifically, we are concerned about proposals for open-ended arbitration, which have been floated as a solution to the problem. If arbitration appears innocuous, it is to a large extent because it is not transparent. Experience suggests that arbitration would be cumbersome to deploy, and highly favorable to those health care providers who charge high prices today. If Congress were to endorse arbitration, it could potentially open the door to a system quite unintended – establishing an inflationary dynamic that accommodates and encourages the rapid growth of costs.

“While we hold different views on the merits of using benchmarks or network matching to address the problem of surprise bills, we are encouraged that the Senate HELP Committee left arbitration out of its most recent legislative proposal. We hope it stays out, and that other committees and members follow their lead.”


Joe Antos, American Enterprise Institute

Saulius “Saul” Anuzis, 60 Plus Association

Josh Archambault, Foundation for Government Accountability

Brandon Arnold, National Taxpayers Union

Doug Badger, Galen Institute and Heritage Foundation​

Tim Chapman, Heritage Action for America​

Lanhee J. Chen, Hoover Institution, Stanford University

Ryan Ellis, Center for a Free Economy​

Kaitlyn Finley, Oklahoma Council of Public Affairs​

Beverly Gossage, HSA Benefits Consulting

Heather Higgins, Independent Women’s Forum

​Dave Hoppe, Hoppe Strategies ​

Ben Ippolito, American Enterprise Institute​

Karen Kerrigan, Small Business & Entrepreneurship Council​

Bethany Marcum, Alaska Policy Forum​

James L. Martin, 60 Plus Association

Tom Miller, American Enterprise Institute​

Mark Pauly, University of Pennsylvania

Daniel Perrin, HSA Coalition

Sally C. Pipes, Pacific Research Institute​

Chris Pope, Manhattan Institute​

Avik Roy, The Foundation for Research on Equal Opportunity​

Thomas Schatz, Council for Citizens Against Government Waste​

Grace-Marie Turner, Galen Institute​

Daniel Weber, Association of Mature American Citizens ​

Joel White, Council for Affordable Health Coverage


To read the Joint Statement online, please visit: