The impact of state surprise medical billing protections on consumers with employer-sponsored health insurance

Abstract

This article used consumer survey data to investigate the impact of state surprise medical billing protections on consumers with employer-sponsored health insurance. State protections were categorized as comprehensive, partial, and none following the Commonwealth Fund (2019). Our results indicated that consumers with employer- sponsored health insurance who lived in states with comprehensive surprise medical billing protections were more likely to report receiving surprise medical bills than those who lived in states with no protections. We offer several explanations for this result, including that state protections do not apply to self-funded health care plans. Regarding differences across ages, we found that consumers ages 45 to 60 were more likely to receive a surprise medical bill, which is consistent with the age distribution of those receiving the highest proportion of surgical and non-surgical procedures. With these results, our study contributes to the health insurance literature by deepening our understanding of surprise medical billing regarding both consumer knowledge and the impact of state regulation.