Lawmakers must investigate high prices for health care | Editorials

“Out of network” sounds like some of that bureaucratic blather that is meaningless to most of us — until we need some costly health care. If you get any part of that care from an “out-of-network” provider, you find out you’re on the hook for the full cost of that service.

Even those with health insurance were finding out about that the hard way if they needed a helicopter ride to get the care they needed. They were getting hit with bills for tens of thousands of dollars because the helicopter ambulance service was out of network and not covered by their insurance.

The Montana Legislature didn’t get everything right when they met earlier this year (as we are finding out with unanticipated revenue shortfalls forcing big budget cuts). But one thing lawmakers got right was intervening in this air ambulance mess.

A pair of bills passed during the last session mandate that insurers and air ambulance services work out a deal on the cost of the service with the insured only responsible for deductibles and co-pays. And as part of their compliance with the new law, Blue Cross and Blue Shield of Montana and Life Flight, an air ambulance service, have struck an agreement to station an in-network helicopter in Bozeman. BCBS insures some 300,000 Montanans, the most of any insurance carrier.

Other air ambulance services are working out deals with insurers to get their services covered by health insurance policies. Only time will tell if the legislation has plugged all the holes in the system or if there will still be cases that slip through the cracks and saddle those who need these services with huge bills.

Why insurers haven’t always been required to cover air ambulance services is one of those nonsensical enigmas that seem to plague our health care system. And why the bills for those services are so sky-high is equally baffling. If lawmakers on both the state and national level really want to do their constituents a favor, they should investigate the exorbitant prices we pay for health care and start demanding some justification.

As far as air ambulance services are concerned, the vast majority of us will, fortunately, never need them. But with this new legislation, if we do, our health insurance policies should cover the costs.

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