Congress Debates Two Approaches to Healthcare Arbitration Under No Surprises Act

The Congressional Research Service provided an overview of the arbitration process related to the No Surprises Act, alongside bill analysis provided by Holland & Knight. Congress is currently considering two distinct legislative solutions to the same issue. One proposal from Frank Pallone would eliminate arbitration and instead pay out-of-network doctors a benchmark based on median in-network rates, while a bipartisan bill would maintain arbitration but penalize insurers that delay payments.

Arbitration awards are paid by insurers, and these costs can flow into the premiums that employers and workers pay annually. The CRS overview noted that from 2023 through 2025, over 4.7 million disputes were filed, with providers winning 85.7% of them, resulting in nearly $15 billion in awards in 2025.