Surprise billing, orthe practice of charging patients for care that is more expensivethan anticipated or not covered by their insurance, has received aflood of attention in the past year. (Photo: Shutterstock)

President Donald Trump on Wednesday instructed administrationofficials to investigate how to prevent surprise medical bills, broadening his focus on drug prices to include other issues ofprice transparency in health care.

Flanked by patients and other guests invited to the White Houseto share their stories of unexpected and outrageous bills, Trumptasked his health secretary, Alex Azar, and labor secretary, AlexAcosta, with working on a solution, several attendees said.

“The pricing is hurting patients, and we've stopped a lot of it,but we're going to stop all of it,” Trump saidduring a roundtable discussion when reporters were briefly allowedinto the otherwise closed-door meeting.

Related: Is outlawing surprise medical bills really inconsumers' best interests?

David Silverstein, the founder of a Colorado-based nonprofitcalled Broken Healthcare who attended, said Trump struck anaggressive tone, calling for a solution with “the biggest teeth youcan find.”

“Reading the tea leaves, I think there's big change coming,”Silverstein said.

Surprise billing, or the practice of charging patients for carethat is more expensive than anticipated or not covered by theirinsurance, has received a flood of attention in the past year,particularly as Kaiser Health News and other news organizationshave undertaken investigations into patients' most outrageousmedical bills.

Attendees said each of 10 invited guests — among them patientsas well as doctors with their own stories of unexpected bills — wasgiven an opportunity to talk, though Trump did not stay to hear allof their stories during the roughly hourlong gathering.

The group included Paul Davis, a retired doctor from Findlay,Ohio, whose family's experience with a $17,850 bill for a simpleurine test was detailed in a KHN-NPR “Bill of the Month” feature lastyear.

Davis' daughter, Elizabeth Moreno, was a college student inTexas when she had spinal surgery to remedy debilitating back pain.After the surgery, she was asked to provide a urine sample andlater received a bill from an out-of-network lab in Houston thattested it. Experts said such tests rarely cost more than $200, notnearly what the lab charged Moreno and her insurance company. Butfearing damage to his daughter's credit, Davis paid the lab $5,000and filed a complaint with the Texas attorney general's office,alleging “price gouging of staggering proportions.”

Davis said White House officials made it clear that pricetransparency is a “high priority” for Trump, and while they did notsee eye to eye on every subject, he said he was struck by theirsincerity.

“These people seemed earnest in wanting to do somethingconstructive to fix this,” Davis said.

Dr. Martin Makary, a surgeon and health policy expert at JohnsHopkins University who has written about transparency in healthcare and attended the meeting, said it was a good opportunity forthe White House to hear firsthand about a serious and widespreadissue.

“This is how most of America lives, and [Americans are] gettinghammered,” he said.

Trump has often railed against high prescription drug prices buthas said less about other problems with the nation's health caresystem. In October, shortly before the midterm elections, heunveiled a proposal to tie the price Medicare pays for some drugsto the prices paid for the same drugs overseas, for example.

Trump, Azar and Acosta said efforts to control costs in healthcare were yielding positive results, discussing in particular theexpansion of association health plans and the new requirement that hospitals post their list pricesonline. The president also took credit for the recent increasein generic drug approvals, which he said would help lower drugprices.

Discussing the partial government shutdown, Trump said Americans“want to see what we're doing, like today we lowered prescriptiondrug prices, first time in 50 years,” according to a White Housepool report.

Trump appeared to be referring to arecent claim by the White House Council of Economic Advisersthat prescription drug prices fell last year.

However, as STAT pointed out in a recent fact check, the report fromwhich that claim was gleaned said “growth in relative drug priceshas slowed since January 2017,” not that there was an overalldecrease in prices.

Annual increases in overall drug spending have leveled off aspharmaceutical companies have released fewer blockbuster drugs;patents have expired on brand-name drugs; and the waning effect ofa spike driven by the release of astronomically expensive drugs to treat hepatitis C. Drugmakersare also wary of increasing their prices in the midst of growingpolitical pressure.

Since Democrats seized control of the House of Representativesthis month, party leaders have rushed to announce investigationsand schedule hearings dealing with health care, focusing inparticular on drug costs and protections for those with preexistingconditions.

Last week, the House Oversight Committee announced a “sweeping”investigation into drug prices, pointing to an AARP report saying the vast majority of brand-name drugs hadmore than doubled in price between 2005 and 2017.

KHN correspondents Shefali Luthra and Jay Hancockcontributed to this report.

Kaiser HealthNews (KHN) is a national health policy news service. It is aneditorially independent program of the Henry J. Kaiser Family Foundation whichis not affiliated with Kaiser Permanente.

Read more:

• Fighting back against “surprise” medicalbills
• Out-of-network providers vex large employerplans
• Balance-billing court cases force hospitals tojustify charges