| Lower health care costs were supposed to be a benefit of a law meant, primarily, to provide relief to patients who unknowingly receive care from providers outside of their insurance networks. In practice, though, the ballooning payouts to providers through the No Surprises Act threaten to raise insurance premiums for everyone. That’s a sliver of the newest report from my colleague, WP Intelligence Lead Health Care Analyst Rebecca Adams. Let’s get into it. When an insurance company and provider can’t agree on the reimbursement amount for an out-of-network medical bill, the two parties go into arbitration in a process laid out by the law, called the No Surprises Act. - The number of claims has skyrocketed: In the first half of this year, Rebecca found that there were 48 percent more disputes than during the same period in 2025.
- The arbitration payouts are growing too: Payments rose to $22 billion from 2022 through 2025, according to a new Georgetown University analysis published Wednesday in Health Affairs. And, in 2025 alone, the total costs were $16.6 billion — nearly 3.5 times higher than the previous year.
Here’s how some employers and insurers say it’s impacting the cost of health care: - Some employers have said the No Surprises Act cases have pushed up costs by 2 percent to 3 percent, according to Garrett Hohimer, vice president for policy and advocacy for employer group Business Group on Health.
- Results of the arbitration process account for at least 1 percentage point of total commercial insurance costs, Dan Kueter, CEO of UnitedHealthcare’s employer and individual insurance business, said on a recent earnings call.
- A health plan offered by the United Service Workers union increased premiums by 1.75 percentage points just to offset the surprise billing arbitration awards.
While the impact is not yet a major factor in driving up insurance premiums, the rising costs and escalating volume of claims could become a bigger problem — especially as new rules have made it easier, and cheaper, for providers to file arbitration claims. HaloMD, one of the leading companies that helps providers submit disputed claims to arbitration and garner large payouts, argues that insurance companies have brought the problem on themselves by underpaying providers in the first place. “If employers had a little bit more transparency into what their [third-party administrator insurance plans] were actually doing in the No Surprises Act space, they might have a different perspective on some of the key cost drivers there,” Patrick Velliky, HaloMD’s chief external affairs officer, told Rebecca. HaloMD alone filed about 27 percent of all the No Surprises Act claims last year, according to the Georgetown analysis. With a motto of “no claim left behind,” the private company brings in more than $2 billion in awards per year, according to a video on its YouTube channel. What’s more: A federal court also recently ordered regulators to go back to the drawing board and rewrite rules establishing what’s known as the qualifying payment amount, or QPA. The figure is meant to represent the median in-network rate as a key benchmark when insurers and providers haggle over out-of-network payments in the arbitration process. The court ruled that regulations had created an artificially low QPA. Experts say, though, that a higher QPA could ultimately push up overall health insurance premiums. → Insurers have long said that a small number of providers and middlemen are gaming the system to garner much higher payouts than would be otherwise paid. Providers counter that insurers aren’t following the law and are failing to pay claims on time. A recent publication by a trade association representing the arbitrators said both sides could do better. What else to watch: The Congressional Budget Office is calling for new research on the law’s impact, saying it “might not have the effects that CBO anticipated.” The Centers for Medicare and Medicaid Services said it’s working to better police the system overall. Meanwhile, lawmakers are reportedly mulling legislation that aims to placate both sides of the industry battle, which is running into opposition. There’s a ton more to Rebecca’s report, so make sure to check it out. Read the full report: “The unexpected costs of the surprise billing law.” The Food and Drug Administration on Wednesday approved a pioneering treatment for pancreatic cancer — a deadly disease that has long resisted medicines — that has nearly doubled patients’ average survival times, The Post’s Daniel Wu reports. - It’s a drug so miraculous that a group of cancer scientists gave Revolution Medicines, the company that developed it, a standing ovation when a researcher presented results from clinical trials at an oncology conference last fall.
- The treatment, known as Rasonque or daraxonrasib, has been hailed as a “landmark” development by researchers. It targets RAS proteins, which drive tumor growth in most pancreatic cancers.
Read the full story: “FDA approves ‘landmark’ pancreatic cancer drug that extends patients’ lives.” The treatment also came into the spotlight earlier this year because former senator Ben Sasse (R-Nebraska) discussed his experience with it while it was still experimental. → The drug approval is also notable for the pathway it took: Daraxonrasib was approved more than six months ahead of schedule. Last October, Revolution Medicines was among the first recipients of the FDA Commissioner’s National Priority Voucher, a controversial pilot program spearheaded by then-commissioner Marty Makary aimed at speeding the review of drugs that address national health priorities. Earlier this year, the FDA cleared expanded access to the experimental drug just two days after receiving the application from Revolution Medicines. The FDA had previously designated daraxonrasib as a breakthrough therapy, which speeds its review process, and classified it as an orphan drug that entitles the company to additional benefits. Heidi Overton’s nomination to lead the FDA is drawing opposition from influential Make America Healthy Again activists, who fear the Trump administration isn’t moving aggressively enough against corporate interests and pesticides, The Post’s Rachel Roubein and Dan Diamond report. The spat came out into the open last week when Alex Clark, a conservative wellness influencer, began publicly sparring with White House spokesman Kush Desai on social media. - Clark has urged her more than 166,000 followers on X to oppose Overton and contact their senators. She has focused on Overton’s involvement in a February executive order calling for increased domestic production of glyphosate, the active ingredient in Roundup.
- Desai responded that the criticism mischaracterizes Overton’s role, arguing the glyphosate order originated with the national security team, and that Overton was brought in near the end and pushed for MAHA-oriented changes.
It’s not yet fully clear whether the rift could present broader obstacles to Overton’s confirmation. However, White House officials, my colleagues report, are frustrated by the attacks, and say that Overton has been a major advocate for MAHA’s priorities in Trump’s second term in her role at the Domestic Policy Council. Overton’s allies point to her role in advancing the movement’s priorities on regenerative agriculture, updating the dietary guidelines and pushing food companies to eliminate artificial dyes. → But her nomination faces another obstacle: Sen. Bill Cassidy (R-Louisiana), who leads the committee responsible for advancing Overton in the Senate, has raised “strong concerns” about her role in the administration’s effort to reduce the recommended shots in the childhood vaccine schedule. Overton stood near the president while he signed an executive order that aims to overhaul said vaccine policy. Read the full story for more: “A rift over a weed killer is dividing a pro-Trump alliance.” Democrats are taking aim at House Republicans over cuts to the nation’s largest food assistance program, rolling out mobile billboards Wednesday in five swing districts, reports The Post’s Mariana Alfaro. - The Democratic Congressional Campaign Committee is targeting Republican Reps. Juan Ciscomani (Arizona), Monica De La Cruz (Texas), Gabe Evans (Colorado), Mike Lawler (New York) and Ryan Mackenzie (Pennsylvani
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