Health groups urge Congress to overhaul No Surprises Act arbitration costs

A coalition representing 67 health-care industry and advocacy groups has urged Congress to revisit the No Surprises Act after arbitration disputes began generating unexpectedly high costs. The groups highlighted that the law’s arbitration, which forces an arbitrator to choose between a single offer from a hospital and an insurer, now often replaces negotiated settlements and yields payouts over six times the local in-network rates.

Providers collected an additional $15 billion in arbitration payments in 2025, a trend analysts say is pushing up premiums for both employers and workers. Senate Health, Education, Labor and Pensions Chair Bill Cassidy plans a roundtable to explore reforms, while Rep. Frank Pallone Jr. is targeting arbitration firms he deems abusive. House Ways and Means Republicans are also examining ways to reduce arbitration expenses. The coalition, led by Families USA, proposes benchmarking disputed amounts to Medicare rates or median in-network fees, arguing that one outlet system lacks guardrails and drives up costs.