President Donald Trump's administration rolled out principles for legislation that include charging patients as if they were getting in-network care when they're treated by out-of-network providers in an emergency. | Saul Loeb/AFP/Getty Images Health Care Trump prods Congress to eliminate 'surprise' medical bills

President Donald Trump is urging Congress to protect patients from "surprise" medical bills — an area of possible consensus despite the fact no one can agree who should pick up the cost.

Trump on Thursday unveiled principles for legislation during an appearance with patients who've been hit with staggering bills for emergency care or when they've gone to a hospital in a health plan's network but were treated by some out-of-network physicians like an anesthesiologist.


“This must end. We’re going to hold insurance companies and hospitals totally accountable,” Trump said.

The administration brushed aside having health providers and insurers use outside arbitration to solve billing discrepancies — an option used in several states that insurer and employer groups oppose.

“We do not have a lot of enthusiasm for arbitration,” a senior administration official said on a call with reporters. “We believe that that would be disruptive.” Officials said they will would work on details with lawmakers.

Trump’s principles include charging patients as if they were getting in-network care when they're treated by out-of-network providers in an emergency.

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They would ensure patients get a single bill, instead of multiple charges weeks or months after treatment. Additionally, patients who have a surgery scheduled would be told in advance if a member of the medical team, such as an anesthesiologist or a radiologist, was out-of-network — and would have to consent before they were treated by that provider.

The pocketbook issue could unite Republicans and Democrats in a Congress that's otherwise fiercely divided over health policy. But health care interests are scrambling to avoid picking up the extra costs now borne by patients. Hospitals, insurers, physicians and employers have flooded congressional health committees with proposed solutions, elevating the issue as lawmakers grapple with other priorities like high drug prices.

A bipartisan group of senators is revising a bill addressing a variety of billing scenarios and is in communication with congressional scorekeepers.

“We're very advanced in our considerations,” Sen. Bill Cassidy (R-La.), who’s leading the group, told POLITICO Wednesday.

Arbitration is an option that's gained favor within the group. "What you can say about arbitration is that empirically it has worked. New York has done it, and apparently stakeholders feel as if it has worked well,” Cassidy said.

However, Senate Health Committee Chairman Lamar Alexander (R-Tenn.) has concerns with arbitration, according to a Senate GOP aide.

Three panels in the House have expressed interest in tackling the issue — and the House Education and Labor Committee held a hearing last month — but the chamber’s panels aren’t as far along in crafting their own bill.