Panel hears bill to allow cash-pay prices to count toward deductibles

The committee heard testimony on House Bill 2540, which would require insurers to credit a covered, medically necessary service paid at a lower cash price toward the insured person's deductible.

Representative Ed Deal said the bill seeks to let consumers shop for lower-cost options and have those savings apply to deductible accumulation. He gave an example from another state where a colonoscopy cash price was $541 but the insurer-negotiated price averaged $2,400; applying the cash price to a patient's deductible can yield substantial out-of-pocket savings. Physician witnesses who operate or represent direct-payment clinics supported the measure, saying cash prices are often substantially lower and reduce administrative burden for providers.

Insurers and plan administrators expressed concerns about claim submission mechanics, verification of provider legitimacy and potential fraud. They also asked for amendments to allow claims to be submitted through insurer systems and to address integrated delivery systems such as Kaiser Permanente. Testimony noted existing pathways for patients who pay providers and then submit claims for reimbursement but said those payments often do not count toward deductibles under current practice.

Supporters said the bill would reward competitively priced providers and could encourage downward price pressure; opponents urged careful operational rules and recommended automated claims paths rather than manual submissions. Lawmakers sought clarifications about enforcement and whether the division of financial responsibility would shift in ways that could raise premiums or affect network adequacy.