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New Survey Shows No Surprises Act Continues to Protect Millions of Americans from Surprise Medical Bills

Press Release

Published Jan 29, 2024 • by AHIP

WASHINGTON, D.C. – (January 29, 2024) – During the first nine months of 2023, the No Surprises Act (NSA) protected Americans from more than 10 million surprise medical bills, according to a new survey by AHIP and the Blue Cross Blue Shield Association (BCBSA).

“The bipartisan No Surprises Act is protecting millions of American families from the indefensible practice of surprise medical billing,” said Mike Tuffin, AHIP president and CEO. “As lawsuits seeking to undermine these vital reforms continue to be filed, it is also essential that the dispute resolution process in the law results in lower health care costs as Congress intended."

The AHIP and BCBSA survey found that the NSA prevented more than 10 million surprise medical bills from health care facilities, providers, and air ambulance providers from reaching patients. Another key finding from the study—67% of health insurance providers indicated that they increased their provider networks since the enactment of the NSA, with no plans reporting decreases in provider networks.

The NSA is working for the vast majority of health insurance and health care providers. In fact, for almost 80% of NSA-eligible claims resolved without the use of the Independent Dispute Resolution (IDR) process—a negotiating process intended for use in limited circumstances—providers accepted the initial payment offered by health insurance providers. However, the AHIP and BCBSA research found a growing and troubling trend—the skyrocketing use of IDR.

Before the law took effect, federal agencies estimated that 17,000 claims would go through the IDR process annually. In fact, between April 15, 2022, and March 31, 2023, 334,828 disputes were initiated through the IDR portal, nearly fourteen times greater than the initial estimate. This increase in the use of the IDR process suggests that certain providers and hospitals may be attempting to exploit the arbitration process solely to increase profits.

“Getting a bill is never fun,” said David Merritt, senior vice president of policy and advocacy for BCBSA. “Getting a surprise bill is awful. I'm proud to see that the No Surprises Act is doing what it’s supposed to—protecting millions of families from unexpected financial hits and the peace of mind that a surprise medical bill won’t cost them their next paycheck.”

AHIP and BCBSA fielded the survey nationwide in November 2023 to a diverse group of health insurance providers (commercial market, self-funded group health, fully-insured group health plans, individual market coverage). It was distributed to 80 health insurance providers. Twenty-one health insurance providers, representing 65% of the total commercial market, responded to the survey via an online tool.

Please click here to view and download the survey results.

About AHIP

AHIP is the national association whose members provide health care coverage, services, and solutions to hundreds of millions of Americans every day. We are committed to market-based solutions and public-private partnerships that make health care better and coverage more affordable and accessible for everyone. Visit to learn how working together, we are Guiding Greater Health.

About Blue Cross Blue Shield Association

The Blue Cross and Blue Shield Association is a national federation of independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans.