An ER visit, a $12,000 bill — and a health insurer that wouldn’t pay

New healthcare policies suggest a new and controversial strategy for reining in health care costs: asking patients to play a larger role in assessing their own medical condition — or pay a steep price.

Emergency room doctors and patients argue that these new policies can often deprive patients of needed care and deter them from using emergency services in the future. They worry that other insurance plans may follow the lead of Anthem, a giant in the industry with more than 40 million members.

Members of Congress and state regulators are pressing Anthem for additional information about how the policy works and which type of visits no longer receive coverage.

“There is real and justified concern about this,” said Renee Hsia, a professor of health policy studies at the University of California San Francisco and practicing emergency physician. “It’s certainly possible other insurers will pick it up, and might do it intentionally because it deters other kinds of care.”

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