Stakeholders Voice Growing Support for Legislation to End Arbitration, Loopholes Within No Surprises Act

Oct 29, 2026 | Arbitration, Blog Post

House Energy and Commerce Committee Ranking Member Representative Frank Pallone, Jr. (NJ-06) recently introduced the Lower Premiums, Faster Payments Act (H.R. 10788), which would stop costly abuse and misuse of arbitration by replacing the No Surprises Act’s independent dispute resolution (IDR) process with market-based, median in-network payments for out-of-network services. 

While the No Surprises Act has successfully protected patients from surprise medical bills, certain out-of-network and private equity-backed providers are exploiting IDR to secure inflated payments at the expense of employers and consumers. Georgetown researchers estimate that IDR generated $22.4 billion in costs from 2022 through 2025 — an unsustainable cost pressure on premiums for employers and working families. 

Employers, consumer and patient advocates, unions, and health policy experts voiced their support for ending provider-led IDR abuse. Here’s what they are saying: 

  • Anthony Wright, Executive Director of Families USA: “Congress needs to close the loopholes in the law that are leading to higher health premiums. We are thrilled Rep. Pallone is proposing this common-sense solution to end the industry abuse of arbitration by replacing it with a market-based benchmark.” 
  • Patricia Kelmar, Healthcare Campaigns director for U.S. PIRG: “We were always wary of arbitration as a way to deal with out-of-network providers’ high charges. It’s time to clean up the law by eliminating the expensive independent dispute resolution system, and get back to tying provider payments to local market rates.” 
  • Blood Cancer United Advocacy: “Patients deserve protection from surprise medical bills, but that protection shouldn’t come at the expense of affordable care. When payment disputes are resolved in ways that drive up healthcare costs, patients and families ultimately pay the price through higher premiums and out-of-pocket costs. We applaud Rep. Pallone for advancing reforms that strengthen the No Surprises Act to ensure that it works as intended and protects patients from unnecessary healthcare costs.” 
  • Katy Johnson, President of American Benefits Council: “Critically, [H.R. 10788] would continue to protect patients from surprise bills and would also lower costs and premiums for consumers and employers. It would also ensure fair compensation for providers and reintroduce incentives for providers to join and stay in network.” 
  • Edwin Egee, Vice President of the National Retail Federation: “The No Surprises Act was an important bipartisan achievement that protected patients from unexpected medical bills. Unfortunately, the arbitration process is increasingly driving unnecessary costs for retailers, who provide affordable coverage for workers and their families. NRF supports Representative Pallone’s effort to preserve those critical patient protections while replacing a costly and overused IDR system with a fair, market-based approach that can help reduce healthcare costs.” 
  • UNITE HERE: “The No Surprises Act arbitration process is driving up costs for our health plans, leaving less money for wage increases. UNITE HERE strongly supports Ranking Member Pallone’s bill, the Lower Premiums, Faster Payments Act, as a way to lower healthcare costs for our members.” 
  • Michael Scott, Executive Director for the National Coordinating Committee for Multiemployer Plans (NCCMP): “Representative Pallone’s bill is an important step in eliminating an unexpected source of healthcare inflation, the IDR process. This protects the 165 million hard-working Americans who receive healthcare through their employment from the predictable results of healthcare inflation, reduced take-home pay and benefits. The bill also ensures that providers are fairly compensated without unnecessary delays.” 
  • Stacie Sasso, Executive Director of the Health Services Coalition: “Our over 300,000 members cannot keep adding costs to their premiums because of the outrageous costs involved in the flawed IDR process and we thank Ranking Member Pallone for offering real reform by introducing H.R. 10788, the Lower Premiums, Faster Payments Act.” 
  • Loren Adler, health economist at the Brookings Institution, speaking with STAT News: “[The bill] would solve two problems: the sky-high payment awards being doled out to providers, and the administrative fees being paid to arbitrators and the government agencies running the program.” 
  • Lindsey Murtagh, a distinguished senior fellow at Brown University’s School of Public Health and an author of the No Surprises Act rules while at the Centers for Medicare and Medicaid Services, speaking with STAT News: “Median in-network rates were originally intended to serve as benchmark payment amounts, but arbitration has allowed for much higher payments. Pallone’s bill would swing the pendulum back, she said. ‘From a cost containment perspective, I think that this would be a very effective approach.’” 

CASMB underscores the importance of Rep. Pallone’s efforts to stop arbitration abuse: “We applaud Ranking Member Pallone for restoring the original mechanism for addressing surprise medical bills and their costs with fair, market-based rates. By replacing the deeply flawed arbitration system, this bill takes an important step forward in safeguarding consumers and employers from untenable IDR costs.”