Pallone Introduces Lower Premiums, Faster Payments Act

Energy and Commerce Committee Ranking Member Frank Pallone, Jr. (D-NJ) announced he’s introducing the Lower Premiums, Faster Payments Act that would fix the No Surprises Act's broken arbitration process, which bad actors have exploited to drive up health insurance premiums for everyday Americans.

“The No Surprises Act has been an overwhelming success when it comes to protecting patients from surprise medical bills. Prior to the law, millions of Americans were on the hook for surprise bills and caught in the middle of payment disputes,” Ranking Member Pallone said. “Today, I’m pleased to say patients no longer receive these outrageous bills, but unfortunately the arbitration process is clearly not working. A few bad actors—largely backed by private equity—are gaming the system, creating backlogs, delaying payments, and driving up premiums. The Lower Premiums, Faster Payments Act will replace the broken arbitration system with a fair and timely payment process that lowers people’s health insurance premiums.” 

Pallone was one of the authors of the bipartisan No Surprises Act in 2020, which took patients out of the middle of surprise billing payment disputes and established an arbitration process between health care providers and payers. The law established guidelines for determining a fair payment amount, but a series of court decisions in lawsuits have weakened those guidelines, resulting in increasingly large awards that overwhelmingly delay payments and drive up insurance premiums for millions of patients.  

Today, a small number of organizations mostly backed by private equity account for the overwhelming majority of disputes filed through the arbitration process. Of the 2.5 million disputes submitted in 2025, approximately 67 percent were submitted by ten provider groups. Taken together, the 15 arbitration firms authorized to handle surprise billing disputes were paid $1.3 billion in fees in 2025 alone, compared to the $885 million these firms received from 2022 to 2024.  

Collectively, the 15 arbitration firms awarded nearly $15 billion in payments to providers in 2025, which will result in higher premiums for consumers and employers. According to an analysis in Health Affairs, the arbitration process contributed to an estimated $22.4 billion in total costs over just four years. For instance, the New York State Employee Plan cited the arbitration award amounts as the primary contributor to the 10 percent premium increase this year.

The Lower Premiums, Faster Payments Act will amend the No Surprises Act by replacing the broken arbitration system with a fairer payment system based on the median in-network rate and require that payments be issued within 30 days of the claim being filed. 

“To help make health care more affordable, Congress needs to close the loopholes in existing law that private equity-backed and corporate firms are exploiting to secure inflated payments — loopholes that ultimately push premiums ever upward,” said Anthony Wright, Executive Director of Families USA. “While the bipartisan No Surprises Act continues to successfully protect patients from unexpected out-of-network medical bills, we need Congressional action to prevent premium increases due to corporate middlemen abusing its arbitration process. Representative Pallone's bill would take commonsense steps to replace the arbitration system with a market-based benchmark that ensures providers receive fair but not inflationary payments that raise costs for everyone. All who worry about health costs need Congress to act urgently to stand up to industry groups that have been profiteering off of the No Surprises Act arbitration process at the expense of consumers." 

Legislative text of the Lower Premiums, Faster Payments Act is available HERE. 

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