A proposal from Sen. Lamar Alexander to end surprise medical bills could advance to the full Senate this week. The bipartisan legislation was shaped by many individual stories, including a mountain biking accident in Tennessee.
Last year, Todd Johnson's teenage son took a nasty spill on the trails. The rough end of a tree stump punctured his forearm. So they went to their local hospital in Knoxville.
"Here at home, I knew — or thought I knew — which hospitals were covered under my insurance," he said.
He paid the co-pay. The doctors yanked out a two-inch hunk of tree protruding from his son's arm. It healed up with a gnarly scar. And they didn't think much else about it.
Then, the bills started arriving in the mail.
One was from the physician staffing firm — an $1,840.15 charge because the doctors weren't in his network.
What this school teacher ran into — a hospital in his network, but a doctor who's not — is now happening to as many as one in five ER patients.
Johnson called his insurer. The company told him not to pay. They said they'd try to work something out.
But he fired off a letter to his senators. Lamar Alexander, who chairs the health committee, incorporated the anecdote into his congressional hearings.
"If I'm expected to be a conscientious consumer of my own health care needs, I need a little more help," Alexander read from Todd's letter during a hearing in June of 2018.
After repeated calls, Johnson's out-of-network charges were forgiven. But soon after, there was yet another mountain biking incident that required a trip to the ER.
"Actually, I brought in a piece of paper I wanted them to sign [to] acknowledge the physicians that will service my child are in network," he said. "And they wouldn't sign that."
Johnson and his son ended up going home — preferring to do without care than risk another surprise bill.