The federal No Surprises Act has saved individual patients about $567 per year in out-of-pocket costs, according to a study published Aug. 27 by The BMJ.
Researchers examined data from 17,351 privately insured adults between 2019 and 2024, comparing those in 18 states that gained protections from surprise billing through the NSA with those that already had similar laws.
Here’s five takeaways from the study:
1. In the newly protected states, average annual out-of-pocket spending fell from $3,674 to $2,922. This finding was consistent across sociodemographic characteristics, including sex, race/ethnicity, poverty status, education level and employment status.
2. No comparable change was observed in states that already had surprise billing protections outside of the NSA.
3. While average out-of-pocket spending decreased, the law did not affect premium contributions or reduce the share of families experiencing “high-burden” medical costs. “High burden” is defined as spending more than 10% of household income on healthcare. Premium spending was flat across intervention and control states, and rates of high-burden medical spending were largely unchanged.
4. The researchers suggested the lack of premium savings may stem from how arbitration under the law unfolds, as providers — especially those backed by private equity — prevail in most payment disputes.
5. Researchers also noted that, while protections against surprise billing appear to be working as intended, enhanced measures will be needed to decrease the overall financial strain on patients. The study contextualizes the NSA within the larger healthcare affordability crisis, noting that, as of 2020, nearly 18% of Americans carried some medical debt, averaging $429 per person.
