“No Surprises? Think Again — Why Patients Need to Stay Alert Under the Trump Administration

If you have to go to a doctor or even a hospital or maybe also a specialist lately, you probably signed a consent form and likely without really reading every word. But from now on – stop doing that.  With the new administration it’s more than ever important to read the fine print. 

Because the federal law meant to protect you from surprise medical bills — the No Surprises Act — which was put into law by Biden, may not be as airtight in practice as it once was in 2022-2024.

The No Surprises Act, passed in 2020 under Biden administration and implemented in 2022, was designed to protect us patients from unexpected out-of-network charges — especially in emergency situations or when you’re treated at an in-network facility but unknowingly seen by an out-of-network provider.

But since the new Trump administration took office in 2025, there’s growing signs that enforcement priorities are shifting. While the law is still technically active, proposed changes could water it down. There are reports of:

• Slowed enforcement of transparency rules

• Proposed changes to the dispute resolution system

• Budget cuts or staffing reductions for the federal agency tasked with enforcing the act

In a bottom line: the rules may be on the books, but how well they’re enforced — and how much you’re protected — could change.

Pay attention to new consent forms which can now include some kind of vague language re:  being treated by “independent contractors” — and see how nowhere does it clearly say you would be notified if any of them were out-of-network. Instead, the burden now is put upon on you, the patient, to know. That contradicts the spirit of the No Surprises Act.

And worse look for in the same form a mention that students or trainees might observe or assist in your care — without giving you the option to opt out unless you proactively asked.

This isn’t a conspiracy. It’s quiet policy erosion and it matters. Just like other consumer protective rollbacks under this current administration you may not be aware of.

So, do this because it’s your right:

• Request a hard copy of any consent forms and review them before signing.

• Strike through and initial any language you don’t agree with (e.g., student observers, vague billing clauses).

• Write your own addendum asserting your rights under the No Surprises Act.

• Ask in writing whether any providers are out-of-network before receiving treatment.

• Educate family and friends — especially those who may not know their rights are shifting.

The law says you’re protected. But laws need enforcement and right now those protections may be quietly slipping under trump. Don’t assume you’re covered just because it’s written down. Ask questions. Read everything. And speak up.

Ps: Policies aren’t hidden — they’re right there in plain sight. You don’t need to rely on headlines or party spin. If you want to know which bills are being passed or how your representatives are voting, go look at the public record. Congress keeps a detailed, up-to-date log of legislation and voting history. Start with Congress.gov.

Some of the most consequential policies have been signed quietly — even in the middle of the night while the public sleeps. It’s not a conspiracy; it’s a tactic. The truth is, you have a right to know what’s being passed which affect you now or in the future.

Use it. Bookmark it. Truth doesn’t hide — it just doesn’t always trend.

Don’t just listen to what they say — look at what they do.