The push to eliminate surprise medical bills


>>Thompson: IF YOU’VE EVER GONE TO THE HOSPITAL AND ENDED UP WITH A BIG BILL FROM A PROVIDER YOU DIDN’T REALIZE WAS OUT OF YOUR INSURANCE NETWORK, CHANCES ARE, YOU GOT WHAT’S CALLED A SURPRISE MEDICAL BILL. IT’S A BIG ISSUE THAT’S GETTING A LOT OF ATTENTION RIGHT NOW FROM POLICYMAKERS ON BOTH SIDES OF THE AISLE. LAST MONTH, PRESIDENT TRUMP EVEN CALLED FOR LEGISLATIVE ACTION ON THE SUBJECT. THIS ISN’T A NEW ISSUE. THREE YEARS AGO, “PBS NEWSHOUR WEEKEND” REPORTED ON EFFORTS IN NEW JERSEY TO CRACK DOWN ON THESE SURPRISE BILLS. HERE ARE THE STORIES OF TWO PATIENTS. AFTER SUFFERING A HEART ATTACK 20 YEARS AGO, LEIGH LEHMAN OF HILLSDALE, NEW JERSEY, DOES WHAT HE CAN TO EAT RIGHT AND STAY IN SHAPE. BUT THE 64-YEAR-OLD COMPUTER CONSULTANT STILL HAS OCCASIONAL HEALTH SCARES. LAST SUMMER, DOCTORS TOLD HIM HE NEEDED A QUINTUPLE HEART BYPASS. BEFORE THE PROCEDURE, HE CONFIRMED BOTH THE VALLEY HOSPITAL, IN RIDGEWOOD, NEW JERSEY, AND HIS SURGEON, ACCEPTED HIS AETNA HEALTH INSURANCE, WHICH HE GETS THROUGH HIS EMPLOYER, A SMALL CONSULTING COMPANY.>>BUT A FEW WEEKS LATER, AFTER THE SURGERY, I GOT A BILL IN THE MAIL.>>Thompson: THE SURPRISE BILL WAS FOR NEARLY $2,200. IT WAS FROM A CRITICAL CARE DOCTOR IN THE INTENSIVE CARE UNIT WHO DID NOT ACCEPT LEHMAN’S INSURANCE.>>OUT OF NOWHERE, SOMEBODY WHO YOU NEVER HEARD OF, I DON’T REMEMBER MEETING, SENDS A BILL. WHY IS HE NOT ACCEPTING THE INSURANCE? WHY IS HE OUT OF NETWORK?>>Thompson: LEHMAN SAYS HE CONTACTED THE HOSPITAL AND INSURANCE COMPANY, BUT THEY TOLD HIM THERE WAS THEY NOTHING THEY COULD DO TO REDUCE THE BILL. SO HE DUG INTO SAVINGS TO PAY IT OFF.>> IT’S A LITTLE STRESSFUL. YOU’RE TRYING TO RECOVER. IT’S MAJOR SURGERY. I MEAN, I FELT LIKE I WAS HIT BY A TRUCK.>>Reporter: SOMETHING SIMILAR HAPPENED TO ANDREW HEYMANN, AN ACCOUNTANT FROM HACKENSACK, NEW JERSEY, WHO HAD HEALTH INSURANCE THROUGH HIS EMPLOYER FROM ANTHEM BLUE CROSS-BLUE SHIELD.>>THERE WAS BLOOD AND GLASS ALL OVER THIS WHOLE PART OF THE PARKING LOT.>>Thompson: TWO YEARS AGO, WHEN HE WAS HELPING A NEIGHBOR MOVE, A LARGE GLASS TABLE SHATTERED, AND A SHARD OF GLASS SLICED INTO HEYMANN’S LEFT ANKLE. AN AMBULANCE TOOK HEYMANN TO THE CLOSEST EMERGENCY ROOM– AT HACKENSACK UNIVERSITY MEDICAL CENTER– WHICH HE KNEW WAS IN- NETWORK. HIS ANKLE WOUND WAS SO DEEP, THE E.R. CALLED THE PLASTIC SURGEON ON DUTY.>>AND HE CAME IN, AND SEWED UP MY LEG IN PROBABLY ABOUT 10 MINUTES.>>Thompson: BUT THAT SURGEON DID NOT ACCEPT HIS INSURANCE. HEYMANN RECEIVED WHAT’S CALLED A “BALANCE BILL.” THE DOCTOR CHARGED CLOSE TO $6,000. BLUE CROSS COVERED ABOUT $860. AND HEYMANN WAS STUCK OWING $5,000.>>I’M THINKING THERE’S NO WAY I’M GOING TO PAY THIS. THIS IS INSANE. AND IT’S KIND OF ALMOST LIKE, WHATEVER IF YOU WANT TO CALL IT, FALSE ADVERTISING, WHEN YOU GET SOME KIND OF A CRAZY BILL FROM SOMEONE WHO’S NOT IN THE NETWORK, AND YOU REALLY HAD NO CONTROL OVER THE FACT THAT THEY WOULD BE THERE.>>Thompson: THE HOSPITAL WOULDN’T DISCUSS THE SPECIFICS OF HEYMANN’S CASE, BUT SAID IT RECOGNIZES “THE CURRENT SYSTEM IS NOT OPTIMAL.” AFTER SIX MONTHS OF FIGHTING HIS BILL AND APPEALING WITH HIS INSURER, HEYMANN DISCOVERED HIS EMPLOYER, A LARGE EDUCATION COMPANY, WAS SUPPOSED TO COVER THE CHARGE, AND THE COMPANY PAID IT OFF. CHUCK BELL, PROGRAMS DIRECTOR AT CONSUMERS UNION, THE ADVOCACY ARM OF CONSUMER REPORTS, SAYS THE FRUSTRATION OF SURPRISE MEDICAL BILLS IS GROWING.>>WE’VE RECEIVED, LITERALLY, THOUSANDS OF STORIES FROM CONSUMERS ALL OVER THE COUNTRY THAT ARE HAVING THIS PROBLEM.>>Thompson: LAST YEAR, “CONSUMER REPORTS” FOUND THAT 30% OF AMERICANS WITH PRIVATE HEALTH INSURANCE HAVE RECEIVED A SURPRISE BILL WHERE THEIR PLAN PAID LESS THAN THEY EXPECTED. OF THOSE, 23% RECEIVED A BILL FROM A DOCTOR THEY DIDN’T EXPECT TO GET A BILL FROM. AND 14% SAID THEY WERE CHARGED HIGHER “OUT-OF-NETWORK” RATES BY DOCTORS THEY THOUGHT WERE IN- NETWORK. BELL SAYS ONE REASON FOR SURPRISE MEDICAL BILLS MAY BE THAT INSURERS ARE INCREASINGLY OFFERING “NARROW NETWORKS;” CHEAPER INSURANCE PLANS THAT GIVE PATIENTS FEWER DOCTORS TO CHOOSE FROM.>>THE PROBLEM HAS BEEN THAT IT’S VERY HARD TO ACTUALLY USE YOUR NARROW NETWORK IN PRACTICE. THAT WHEN YOU ACTUALLY GO TO A HOSPITAL OR AN EMERGENCY ROOM, YOU INEVITABLY RUN INTO PHYSICIANS AND PROVIDERS THAT ARE OUT-OF-NETWORK, AND THEN THOSE COSTS QUICKLY MOUNT UP.>>Thompson: BELL SAYS SURPRISE BILLS HAVE BEEN A PROBLEM FOR A LONG TIME, BUT IT’S POSSIBLE MORE PEOPLE ARE GETTING THEM, BECAUSE MORE PEOPLE ARE INSURED. SINCE THE AFFORDABLE CARE ACT PASSED IN 2010, 20 MILLION MORE AMERICANS HAVE HEALTH INSURANCE.>>AND PROBABLY MOST OF THOSE PATIENTS DO NOT HAVE VERY RICH OR GENEROUS OUT-OF-NETWORK COVERAGE. SO, WHEN THEY GET A BILL, THEY MAY HAVE TO PAY THE WHOLE THING BY THEMSELVES.>>Thompson: LEIGH LEHMAN’S $2,200 BILL FOR HIS HEART BYPASS WASN’T HIS FIRST SURPRISE BILL. THE YEAR PRIOR, HE WAS HIT WITH A $4,500 BILL FOR A VISIT TO AN EMERGENCY ROOM THAT TURNED OUT TO BE OUT-OF-NETWORK. LEHMAN SOLD SOME PROPERTY AND USED MONEY SET ASIDE FOR HIS DAUGHTER’S COLLEGE TUITION TO PAY HIS BILLS. YOU MAKE A GOOD SALARY.>>YEAH.>>Thompson: YOU HAVE WHAT YOU CALLED GOOD HEALTH INSURANCE.>>YES.>>Thompson: DID YOU EVER THINK YOU’D BE STRUGGLING TO PAY MEDICAL BILLS?>>NO. IT’S PROBABLY GOING TO TAKE A COUPLE OF YEARS BEFORE WE GET BACK ON TRACK.>>Thompson: WE WONDERED HOW PATIENTS LIKE LEHMAN END UP SEEING OUT-OF-NETWORK DOCTORS AT AN IN-NETWORK HOSPITAL. NEUROLOGIST JOHN NASR HAS A PRIVATE PRACTICE IN NEW JERSEY AND SEES PATIENTS AT THE VALLEY HOSPITAL, WHERE LEHMAN GOT HIS BYPASS. BUT NASR IS NOT ON STAFF THERE. INSTEAD, TO GET PAID WHAT HE THINKS IS A FAIR RATE, HE HAS TO NEGOTIATE HIS OWN INSURANCE CONTRACTS. AS A RESULT, HE’S NOT IN-NETWORK WITH EVERY PLAN THE HOSPITAL ACCEPTS.>>OVER THE YEARS, INSURANCE COMPANIES HAVE TYPICALLY REDUCED PAYMENT, YEAR AFTER YEAR, TO THE POINT THAT MANY INSURANCE PLANS PAY BELOW WHAT MEDICARE PAYS. AND THIS BECOMES UNSUSTAINABLE. DOCTORS CANNOT PRACTICE LIKE THAT.>>Thompson: NASR SAYS EVEN WHEN HE IS IN-NETWORK, SOME PATIENTS WITH HIGH DEDUCTIBLES ARE SURPRISED BY WHAT THEY OWE. WHEN HE IS OUT OF NETWORK, NASR IS PERMITTED TO BILL AT A HIGHER RATE TO THE INSURANCE COMPANY AND PATIENT. SO, A PATIENT’S DONE HIS OR HER RESEARCH. THEY FOUND A HOSPITAL THAT’S IN- NETWORK. THEY’VE FOUND A PROVIDER THAT’S IN-NETWORK. BUT THEN THEY END UP SEEING A DOCTOR LIKE YOU, WHO’S NOT IN- NETWORK. THE PATIENT WOULD PROBABLY SAY, “THIS ISN’T FAIR.”>>YES, IT IS NOT FAIR FOR THE PATIENT, I AGREE WITH YOU. AS A PRACTICE, OUR POLICY IS TO WORK WITH THE PATIENT ON OUT-OF- NETWORK PAYMENT. SO, WE UNDERSTAND IT IS A HARDSHIP FOR THE PATIENT WHEN THEY ARE SEEN URGENTLY BY A PROVIDER WHO’S OUT-OF-NETWORK, AND THEY DID NOT ANTICIPATE THAT.>>Thompson: DOESN’T THE DOCTOR THEN HAVE A RESPONSIBILITY TO INFORM THE PATIENT, “HEY, I’M NOT IN YOUR NETWORK.”>>IF I’M TAKING CARE OF YOU IN AN EMERGENCY, I DON’T EVEN LOOK AT YOUR INSURANCE. BECAUSE WE DON’T WANT ANYTHING WE DO TO BE SWAYED BY INSURANCE.>>Thompson: AND NEITHER DO HOSPITALS, SAYS JOE DEVINE, THE PRESIDENT AND C.E.O. OF KENNEDY HEALTH, A CHAIN OF HOSPITALS AND CLINICS IN SOUTHERN NEW JERSEY. HE SAYS KENNEDY CAN ONLY REQUIRE ITS CONTRACTED DOCTORS TO PARTICIPATE WITH THE SAME NETWORKS IT DOES.>>WE CANNOT LEGALLY FORCE THE INDEPENDENT DOCTORS TO PARTICIPATE IN CONTRACTS. UNFORTUNATELY, WHAT’S HAPPENING IS THEY’RE SENDING BILLS TO PATIENTS, AND WHAT WE’D LIKE TO DO IS COME UP WITH A SOLUTION WHERE WE DO NOT PUT THE PATIENT IN THE MIDDLE OF THIS.>>Thompson: WHEN A PATIENT WALKS THROUGH YOUR DOORS, DOESN’T THE HOSPITAL HAVE AN OBLIGATION TO SAY TO THEM, “HEY, YOU MAY BE IN-NETWORK AT THIS FACILITY, BUT NOT ALL THE DOCTORS YOU SEE MAY BE IN NETWORK.”>>IN THE EMERGENCY SITUATION, MOST PEOPLE ARE NOT THINKING ABOUT IT. WE’RE NOT GOING TO HAVE ALL OF A SUDDEN SOMEONE COME OVER AND SAY, “WELL, YOU KNOW, YOU MAY GET AN OUT-OF-NETWORK BILL.” THAT’S NOT WHAT WE’RE HERE FOR. WHEN THEY’VE DECIDED TO DO AN ELECTIVE PROCEDURE, THE HOSPITAL DOES HAVE NOTIFICATION FORMS THAT ACTUALLY ALLOWS THEM TO UNDERSTAND IT AND WHAT THEY MAY BE RESPONSIBLE FOR.>>Reporter: WHAT DOES THAT LOOK LIKE? YOU’RE SENDING A LETTER, A PHONE CALL?>>WE HAVE A VOLUNTARY SHEET THAT KIND OF SHOWS THEM THAT THEY’RE OUT-OF-NETWORK AND WHAT THEIR RESPONSIBILITIES WOULD BE. WE ALSO HAVE IT ON OUR WEBSITE.>>Thompson: HOWEVER PATIENTS ARE NOTIFIED, DOCTORS STILL COMPLAIN THAT THEY’RE OUT-OF- NETWORK BECAUSE INSURERS DON’T PAY THEM ENOUGH. BUT KEVIN CONLIN REJECTS THAT ARGUMENT. HE’S THE CHIEF OPERATING OFFICER OF HORIZON BLUE CROSS BLUE SHIELD, NEW JERSEY’S LARGEST HEALTH INSURER.>>MORE THAN FOUR OUT OF EVERY FIVE PHYSICIANS IN THE STATE ARE IN-NETWORK WITH US. SO, FOUR OUT OF FIVE FIND WHAT WE MAKE AVAILABLE TO THEM TO BE REASONABLE.>>Thompson: CONLIN SAYS CARRIERS ALSO TAKE A HIT WHEN DOCTORS AND HOSPITALS CHARGE THEM AT OUT-OF-NETWORK RATES, BECAUSE THERE’S NO LIMIT TO WHAT THEY CAN CHARGE. HE ESTIMATES NEW JERSEY’S INSURERS PAY AROUND $2 BILLION A YEAR TO COVER OUT-OF-NETWORK CARE.>>IT CONTRIBUTES SIGNIFICANTLY TO OUR PREMIUM EXPENSE THAT’S ABSORBED BY ALL NEW JERSEYANS.>>Thompson: AND THAT’S WHY INSURERS ARE PUSHING THE STATE LEGISLATURE TO LIMIT THE AMOUNT DOCTORS AND HOSPITALS CAN CHARGE, BUT DOCTORS AND HOSPITALS STRONGLY OPPOSE THAT.>>SO AS AN INDUSTRY, WE NEED TO MAKE SURE WE PROTECT THE ABILITY FOR THE INDIVIDUAL HOSPITALS TO BE ABLE TO NEGOTIATE FAIR RATES WITH THE INSURANCE COMPANIES.>>Thompson: THIS STAND-OFF IS LARGELY WHAT’S HOLDING UP A BROADER BILL IN THE NEW JERSEY LEGISLATURE. IT’S ONE OF 28 STATES CONSIDERING PROTECTIONS FOR PATIENTS AGAINST SURPRISE MEDICAL BILLS. FOUR OTHERS– ILLINOIS, FLORIDA, NEW YORK AND CONNECTICUT– HAVE ALREADY PASSED LAWS.>>FOR SO MANY NEW JERSEY FAMILIES, THEY JUST CAN’T AFFORD IT.>>Thompson: STATE SENATOR JOE VITALE IS A SPONSOR OF NEW JERSEY’S BILL. IT WOULD MANDATE MOST DOCTORS TO PARTICIPATE IN THE SAME NETWORKS AS THE HOSPITAL, REQUIRE DOCTORS AND HOSPITALS TO NOTIFY PATIENTS IF THEY ARE NOT IN NETWORK, BAN DOCTORS FROM BALANCE BILLING AND SET UP AN ARBITRATION SYSTEM TO PRESS PROVIDERS TO DEFEND THEIR BILLS, AND INSURERS TO DEFEND THEIR RATES.>>IN THE END, THERE’S GOING TO BE AN UNDERSTANDING, YOU KNOW, WHAT BILL IS GOING TO BE FAIR, AND WHAT REIMBURSEMENT WILL BE FAIR. AND IF YOU ARE EXTREME IN EITHER ONE OF THOSE CIRCUMSTANCES– WHETHER YOU’RE THE PROVIDER OR THE DOCTOR OR THE INSURANCE COMPANY– YOU’RE NOT GOING TO WIN.>>Thompson: BUT AFTER YEARS OF PRESSURE FROM CONSUMER GROUPS, AND NEGOTIATIONS, INCLUDING A STATE ASSEMBLY HEARING THIS PAST WEEK, THE BILL HAS GONE NOWHERE. WHY HASN’T THIS PASSED?>>WELL, THE INTEREST GROUPS, WHETHER IT’S THE HOSPITAL SYSTEM, OR THE MEDICAL SOCIETY, OR THE INSURANCE COMPANY, WE KIND OF TRY TO, WE GET TO WHERE WE’RE CLOSE TO AN AGREEMENT, SUDDENLY THE GOALPOST SHIFTS A LITTLE BIT.>>Thompson: SO UNTIL NEW JERSEY PASSES A LAW, PATIENTS LIKE LEIGH LEHMAN ARE LARGELY ON THEIR OWN. THE HOSPITAL WHERE LEHMAN HAD HIS BYPASS WOULDN’T DISCUSS THE SPECIFICS OF HIS CASE, BUT SAID, MORE THAN 90% OF ITS PHYSICIANS ACCEPT THE SAME INSURANCE THAT IT DOES, AND, IT INFORMS PATIENTS ABOUT THE OTHER DOCTORS WHO MAY NOT. AFTER NEWSHOUR CONTACTED AETNA, LEHMAN’S INSURER, THE COMPANY REVIEWED HIS CASE. IT TOLD US LEHMAN WAS NOT, IN FACT, RESPONSIBLE FOR THE $2,200 BALANCE BILL HE RECEIVED. AND THAT IT WILL BE REIMBURSING HIM FOR WHAT HE PAID. BUT, LEHMAN IS STILL PAYING OFF THAT EARLIER $4,500 EMERGENCY ROOM BILL.>>IT GETS A LITTLE CRAZY. IT GETS TO THE POINT WHERE YOU’RE RELUCTANT TO GO SEE THE DOCTOR.>>Thompson: FOR MORE ON THE STEPS LAWMAKERS ARE TAKING TO TACKLE SURPRISE MEDICAL BILLS, I’M JOINED BY RACHEL BLUTH, A REPORTER FOR KAISER HEALTH NEWS. RACHEL, THANK YOU SO MUCH FOR BEING HERE.>>THANKS, MEGAN.>>Thompson: I WANTED TO FIRST START OUT BY ASKING YOU HOW PREVALENT THIS IS. I MEAN, AFTER OUR STORY AIRED, I ACTUALLY GOT A SURPRISE MEDICAL BILL. IT WAS KIND OF A TEXTBOOK CASE. I WENT TO AN E.R. AND THEN GOT A BILL FOR OVER $900 FROM A DOCTOR WHO WASN’T IN MY NETWORK. I WANTED TO JUST ASK YOU, HOW OFTEN DOES THIS HAPPEN?>>THEY’RE REALLY PREVALENT. SOME STUDIES SAY THAT UP TO ONE IN FIVE EMERGENCY ROOM VISITS COULD RESULT IN A SURPRISE BILL. OVER $100,000 FOR A HEART ATTACK, $50,000 FOR AN AIR AMBULANCE RIDE. IT IS IMPORTANT TO REMEMBER THAT EVEN THOUGH THIS IS SOMETHING THAT HAPPENS A LOT IN EMERGENCY DEPARTMENTS, IT CAN HAPPEN IN PLANNED PROCEDURES AS WELL. YOU PICK A HOSPITAL THAT IS IN NETWORK, YOU PICK A SURGEON THAT IS IN NETWORK AND THEN YOU ARE SEEN BY AN ANESTHESIOLOGIST WHO DOESN’T TAKE YOUR INSURANCE AND YOU ARE HIT WITH A SURPRISE BILL.>>Thompson: IS THIS SOMEHOW GETTING WORSE OR IS IT HAPPENING MORE OFTEN THESE DAYS?>>I DON’T KNOW IF IT IS GETTING WORSE, BUT YOU ARE SEEING A LOT OF HIGH DEDUCTIBLE PLANS NOWADAYS, WHERE PATIENTS HAVE A LOT OF UPFRONT COSTS THAT THEY HAVE TO PAY BEFORE THEIR INSURANCE REALLY STARTS TO KICK IN. SO, CONSUMERS MIGHT BE A LITTLE BIT MORE SENSITIVE TO IT, BECAUSE THEY ARE HAVING HIGHER OUT-OF-POCKET COSTS THESE DAYS, AND MORE OF THEIR COSTS THAT THEY HAVE TO PAY THEMSELVES.>>Thompson: THIS SEEMS LIKE ONE OF THE VERY FEW ISSUES THAT IS ACTUALLY GAINING MOMENTUM IN WASHINGTON THESE DAYS, THAT LAWMAKERS ON BOTH SIDES OF THE AISLE ARE ACTUALLY COOPERATING ON. TELL US, WHAT IS GOING ON DOWN THERE?>>THERE IS A TON OF BIPARTISAN SUPPORT TO FIX THIS PROBLEM. PRESIDENT TRUMP HAS SAID THAT HE WANTS TO TACKLE SURPRISE MEDICAL BILLING. THERE ARE PROPOSALS IN THE HOUSE, THERE’S PROPOSALS IN THE SENATE, THERE HAS BEEN A NUMBER OF CONGRESSIONAL HEARINGS ABOUT IT IN THE PAST FEW MONTHS. SO THERE IS DEFINITELY A LOT OF MOMENTUM GOING FORWARD.>>Thompson: I MEAN, HOW LIKELY IS IT THAT EVERYBODY WILL BE ABLE TO COME TO THE TABLE AND COME TO AN AGREEMENT ON ALL OF THIS?>>THAT’S THE MILLION DOLLAR QUESTION. SO, DESPITE THE FACT THAT REPUBLICANS AND DEMOCRATS, CONGRESS AND THE PRESIDENT ARE ALL WORKING TOGETHER ON THIS, THERE ARE STILL A LOT OF COMPETING INCENTIVES IN THE HEALTHCARE INDUSTRY. DOCTORS AND HOSPITALS ARE A LITTLE BIT NERVOUS ABOUT THIS IDEA OF RATE SETTING. THEY ARE WORRIED THAT THEY ARE NOT GOING TO BE REIMBURSED AT A HIGH ENOUGH RATE TO COMPENSATE FOR THEIR SERVICES. INSURANCE COMPANIES AREN’T THRILLED WITH THE IDEA OF ARBITRATION BECAUSE THEY ARE WORRIED IT COULD LEAD TO HIGHER MEDICAL COSTS DOWN THE LINE, IT COULD CAUSE SOME INFLATION IN THE INDUSTRY. SO EVERYONE IS TRYING TO GET ON BOARD AND GET ON THE SAME PAGE RIGHT NOW, PLUS WE ARE DEALING WITH A KIND OF CRAMPED LEGISLATIVE CALENDAR. THERE IS A LOT OF OTHER STUFF THAT HAS TO HAPPEN THIS SUMMER. THEY HAVE TO FUND THE GOVERNMENT, RAISE THE DEBT CEILING, PRESIDENTIAL ELECTION SEASON IS ABOUT TO START UP, SO ALL OF THESE THINGS ARE POSSIBLY IMPEDIMENTS OR HURDLES THAT COULD MAYBE SLOW DOWN SOME OF THE BIPARTISAN MOMENTUM. BUT THAT BEING SAID, SENATOR LAMAR ALEXANDER, WHO IS THE CHAIR OF ONE OF THE HEALTH POLICY-MAKING COMMITTEES IN THE SENATE, HE HAS SAID THAT HE HAS A PROPOSAL, AND HE WANTS IT ON THE FLOOR TO BE VOTED ON BY JULY. AND HOPEFULLY GET TO THE PRESIDENT.>>Thompson: GREAT. RACHEL BLUTH, FROM KAISER HEALTH NEWS. THANK YOU SO MUCH FOR BEING WITH US.>>THANKS MEGAN.

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