Bungling the Easy Stuff

Hospitals are still overcharging the poor. Obamacare was supposed to fix that too. What went wrong?

In 2008, Emilia Gilbert, 61, a school-bus driver, was taken to the emergency room at Bridgeport Hospital, where she was treated for some cuts and a broken nose. She left a few hours later with a bill for $9,418, which included $6,538 for CT scans and $239 for a routine blood test. The charges, I found, were based on something called the hospital chargemaster–a list of hugely inflated prices that no one could explain or defend.

But that was before Obamacare.

Tucked onto page 737 of the law, enacted on March 23, 2010, is a provision that was supposed to eliminate that kind of dunning and overbilling.

That’s a big deal. And it’s been black-letter law for more than 3½ years.

So how can it be that, two months ago, Jeremy Kopylec, a warehouse worker who lives in Northford, Conn., was sued by Yale–New Haven Hospital for $6,129? The suit, filed on Oct. 3, has to do with the bill Kopylec incurred four years earlier, when he was taken to the emergency room after what he says was a “minor motorcycle accident.”

At the time of the accident, Kopylec says, he had just gotten a job following a period of unemployment, but “my insurance hadn’t kicked in yet. So they came after me for the whole bill … I told them I could not afford it.”

That Kopylec did not get the protection that Obamacare now requires is not a matter of Yale–New Haven violating the law. It’s not about a website not working. Nor is it about Republican efforts to sabotage the law or some judge blocking it.

Instead, the rules were not drafted and published in the Federal Register until June 26, 2012–more than two years after Obamacare was passed. And that was just an initial draft called “Proposed Regulations.” The American Hospital Association then complained–no surprise–that the drafted rules were too prescriptive.

Nothing has happened since. No final rules have been issued. So there are still no restraints on hospital bill collections or chargemaster charges for the neediest patients.

Obamacare is the President’s signature domestic achievement. It’s bad enough that the design and launch of its insurance-exchange website was bungled and required emergency treatment. But at least for that there is the excuse, lame though it may be, that building this gargantuan e-commerce platform was hard.

But that they also haven’t yet delivered on the easy stuff related to the President’s highest priority suggests that the Obama team was so lacking when it came to turning law into reality–better known as governing–that the website never had a chance.

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