WASHINGTON, D.C. – A new Government Accountability Office (GAO) report finds the No Surprises Act (NSA) – signed into law by President Trump in 2020 – is benefitting patients by successfully pushing the health care market towards more in-network care and fewer surprise bills, reinforcing that full and faithful implementation of the law is the next critical step to lock in these gains and lower costs for families.
Ways and Means Committee Chairman Jason Smith (MO-08) issued the following statement:
“This GAO report confirms what we hoped to see: the No Surprises Act is protecting patients and encouraging more care to be delivered in-network, which means fewer surprise bills and more certainty for families. The report underscores further improvements for patients are possible if the law is fully carried out as Congress wrote it, which the Biden Administration’s regulatory structure failed to provide. This will ensure Americans see the full affordability and transparency benefits the NSA promised.”
The GAO review—mandated by Congress following passage of the NSA in 2020—examined provider network participation and payment trends in four specialties – emergency medicine, radiology, anesthesiology, and air ambulance – historically associated with surprise billing, before and after the law took effect in 2022.
According to GAO’s findings, after years of declining in-network participation prior to the NSA, all of the targeted specialties have either seen increases in the share of claims billed in-network since the law’s implementation, or reversals in market trends that led to patients receiving surprise bills. Higher in-network participation reflects stronger contracting relationships between providers and insurers, leading to more predictable reimbursement and fewer billing disputes that can leave patients caught in the middle.
These trends indicate the NSA is functioning as Congress intended—holding patients harmless from surprise bills while encouraging providers and insurers to resolve payment issues without shifting costs onto families.
However, GAO’s findings also come as several statutory requirements remain only partially implemented, as Ways and Means Republicans have repeatedly documented since the law’s passage. Completing these provisions would build on the positive market response already underway and further strengthen patient protections and affordability:
- Clarifying and simplifying claim eligibility for the independent dispute resolution (IDR) process.
- Improving transparency around qualified payment amounts used in arbitration.
- Requiring insurers to provide Advanced Explanations of Benefits so patients can better anticipate health care costs and make informed decisions.
Read the GAO report here.