Authors
On July 30, 2026, Oregon Senator Ron Wyden, Ranking Member of the Senate Finance Committee, released a Request for Information (RFI), Health Coverage That Works for Everyone, as part of a forward-looking effort by the Committee’s minority party members to reform health care coverage across the country.
It is the second in a series of such requests, following a June 2026 RFI focused on lowering prescription drug prices.
Asante is reviewing the proposal and plans to formally submit comments. While many details remain subject to further analysis and legislative development, several concepts outlined in the RFI align with challenges Asante and our patients grapple with every day.
Areas of strong alignment
The RFI includes several proposals that could help reduce barriers to care, improve coverage stability and strengthen patient access. These proposals, if successful, could improve affordability for patients and strengthen the financial sustainability of safety-net hospitals.
- Reforming prior authorization, claims denials and appeals. The RFI highlights growing concern about insurer utilization management practices and seeks recommendations to reduce unnecessary administrative burden on patients, hospitals and clinicians. It also focuses on making coverage decisions more transparent and ensuring patients have meaningful opportunities to challenge denials of care.
- Measuring affordability more completely. The proposal recognizes that affordability includes more than monthly premiums. It seeks feedback on policies that consider total patient costs, including deductibles, coinsurance and out-of-pocket spending. This could help increase access to care for patients, while reducing uncompensated care for providers.
- Reducing cost-sharing at the point of care. The RFI discusses limiting deductibles for non-shoppable services such as emergency and inpatient care, and requests input on extending low- or no-cost-sharing access to services such as primary care, behavioral health and urgent care before patients meet their deductible.
- Quantifying the administrative burden on providers. The RFI expressly identifies hospitals among the parties that bear the operational cost of insurer-driven processes and asks for information on the burden associated with prior authorizations, denials and appeals. Asante, like most hospitals and health systems, experiences these challenges daily, and as we continue down a pathway of constrained resources, time spent navigating complex administrative requirements instead of providing patient care has a greater impact on the communities we serve.
Coverage expansion
The RFI also explores broader reforms, including public option proposals, Medicare-type coverage alternatives and other pathways to expand access to health insurance.
Asante supports efforts that expand affordable coverage and strengthen access to care. More insured patients generally means better access to preventive services, stronger continuity of care and less uncompensated care across the health system.
At the same time, provider payment adequacy must be treated as a condition of support for any proposal involving Medicare-based payment methodologies, not merely a factor to weigh, particularly for rural providers and safety-net providers.
As we have written about recently, Medicare-benchmarked rates will create disastrous system instability that can threaten access and overall sustainability, and preserving the overall rural health care system will depend on getting payment models right.
A policy idea long overdue: Patient Cost-Sharing
There are many aspects of the current health insurance landscape that inefficiently and unfairly shift administrative burden onto health systems and independent physician practices that should be dramatically re-imagined.
One clear example that Asante would add to the list of policies being considered is the collection of patient cost-sharing obligations.
Health insurers (including government payers) should assume responsibility for collecting patient deductibles, copayments and coinsurance and remit full contracted reimbursement directly to participating providers. Because insurers (and the government) design benefit structures, track deductible and out-of-pocket information in real time and already maintain premium billing and payment collection systems, they are better positioned than providers to administer patient financial responsibility efficiently and accurately. The practice of doctors and hospitals collecting payments from insured patients has never made sense. The insurance agreement or coverage eligibility is between patients and their insurance company – or in the case of Medicare and Medicaid, between the patient and the government. Doctors and hospitals need to be removed from the middle of this financial collection scheme.
Under the current model, hospitals and independent physician practices are required to perform numerous administrative functions associated with insurer-designed cost-sharing requirements, including:
- Verify eligibility
- Determine deductible status
- Estimate patient responsibility
- Bill the insurer
- Wait for adjudication
- Generate patient statements
- Manage payment plans
- Handle collections and bad debt
These activities impose substantial administrative costs on providers and divert resources away from patient care, despite the fact that the deductible and copayment obligations are created by the insurer’s benefit design.
Holding commercial insurers and government programs accountable for cost-sharing collection would reduce administrative burden, improve billing accuracy and transparency, enhance the patient experience through consolidated billing and allow health systems to focus on their primary mission of delivering high-quality care – rather than serving as collection agents for insurance companies.
Looking ahead
The Finance Committee is accepting comments through October 2, 2026. The discussion represents an opportunity to address persistent challenges affecting patients and health care systems across the country, and Asante looks forward to participating in that conversation and sharing the perspective of the patients, providers and communities we serve.
