Surprise Medical Bill Fix Could be On the Way

March 25, 2024

Felicity Ropp

Policy Analyst

Have you ever endured a medical procedure and weeks afterward received a shockingly large bill? This is known in policy world as “Surprise Billing.”  

You’re not alone.

Far too often, a South Carolinian goes to a clinic or hospital to receive necessary medical care without knowing what that service will cost. It’s only after the fact, when providers and third-party insurance payers kick in that he or she discovers that unexpected out-of-pocket costs can be thousands of dollars.

These “surprise bills” can create tremendous financial hardship; a recent study found that 56% of Americans can’t afford a $1,000 emergency expense, and that number is undoubtedly higher in the Palmetto State, where our poverty rate is the tenth highest in the nation.

Eliminating “surprise billing” and giving South Carolinians transparency when it comes to healthcare costs allows consumers to “shop” between medical providers for the best cost available, and the free market will drive down healthcare costs for all consumers.

Palmetto Promise first called for this “Right to Shop” in healthcare back in 2016.

We wrote then that, “If ‘Right to Shop’ is adopted in South Carolina, patients and insurance companies will save money, healthcare providers will have incentive to lower health care costs, and South Carolinians will have greater knowledge of the type and quality of care available to them in their area.”

In 2019, we dove further into the concept of “surprise billing” and “Right to Shop,” and, in 2020, we were pleased to see the Trump Administration take actions to promote healthcare transparency. Bipartisan efforts in Congress have worked to further this cause.

However, more action for healthcare freedom and transparency is needed here at the state level.

That’s why we were glad to see H.4622 (primary sponsor Rep. Heath Sessions) receive a subcommittee hearing in the SC House last week. This bill would take steps toward combatting surprise billing and require healthcare providers to give patients an itemized bill for healthcare services.

Palmetto Promise Senior Fellow Dr. Oran Smith testified in favor of this legislation and urged lawmakers to prioritize healthcare transparency this legislative session.

Listen to his testimony here:


H.4622 now goes to the full House Medical, Municipal, and Military (3M) committee, with a hearing on March 26. South Carolina lawmakers should prioritize this important legislation and consider amending it to establish even stronger protections for healthcare consumers and promote a Right to Shop for their healthcare. (The current version of the bill departs from the original proposal years ago, which required an itemized bill before a healthcare service is rendered.)

The 125th General Assembly has already taken significant steps to promote healthcare freedom by repealing South Carolina Certificate of Need law. We hope they will continue this momentum with healthcare price transparency.