Insurance gap leaves patients on the hook for unexpected hospital bills

Jackson, Miss. — Medical debt is the leading cause of bankruptcy in the U.S. and a recent survey found 57 percent of American adults have received a surprise medical bill, often for treatment they later learned was “out of network.”

Michelle Mills remembers the day she rushed her son Blake to the hospital after he broke his nose.

“I called admissions. I said, ‘Are y’all still in network with First Health?’ And he said, ‘Yes, we are.’ I thought OK, i’m on my way,” she said.

The Jackson area hospital was in network. But the emergency room care was not. Four months later, that cost Mills an additional $1,800.

Nearly 65 percent of hospitals across the country use emergency rooms staffed by outside companies. It’s a loophole that allows providers to charge patients more because the emergency rooms are considered out of network.

But it’s illegal in Mississippi, thanks to a 2013 state law, which State Rep. Gary Chism helped to pass. The problem is there’s no power to enforce it.

“There’s no teeth behind that bill. And we need to rectify that and put someone in charge,” Chism said.

Chism said a move to fix that has stalled.

“This is an election year and there were some concern that this might not be the best year to do it,” he said.

“We’re not asking for any new legal protections. We’re just asking that the law be enforced and that the illegal activity by providers stop,” said Roy Mitchell, director of the Mississippi Health Advocacy Program.

Mills did get her bill reduced to $285. But she’s worried about those who could be taken advantage of.

“I think about older people or people who have not experienced anything like this. They’re going to feel like they’re obligated to that, you know, pay that,” she said.

It’s an extra cost many can ill afford to pay.

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