A federal law designed to shield patients from unexpected medical bills may be producing an unintended consequence: higher insurance premiums. That is the central finding of a new study published this week in the journal Health Affairs, with implications for Colorado Springs residents who carry employer-sponsored or individual health coverage.

Researchers found that the No Surprises Act, which addresses surprise medical billing for care received out-of-network, has driven up arbitration costs between doctors and insurers, hitting $22.4 billion in 2025. The study found evidence that those costs are a reason for employers and insurers to raise premiums.

At the heart of the cost surge is a dispute-resolution mechanism built into the law. The Independent Dispute Resolution process brings in a neutral third party to determine the appropriate payment when an insurer and provider cannot reach an agreement; the arbiter asks both sides to submit proposals with supporting documentation and then selects the winning proposal while weighing several factors, with the losing party also paying additional fees. In 2025, the median provider award was 445% higher than averages paid by in-network insurers to providers.

"We actually think our estimate is conservative," said Jack Hoadley, one of the authors of the study and a professor at Georgetown's McCourt School of Public Policy. He added that "the time may, in fact, be ripe to revisit [the law] to realize the law's original cost containment goals without jeopardizing the consumer protections that are really the main reason this law got passed in the first place."

Researchers also identified which providers are fueling the bulk of disputes — and the answer surprised them. Costs have not primarily been driven by providers the bill was intended to target, such as air ambulance services; instead, surgeons and neurologists made up most disputes, and awards decided by arbiters in those negotiations appear to have no limit.

Despite the mounting costs, the study's authors acknowledged the law is achieving part of its stated mission. The law is technically working — providers won approximately 85% of disputes in 2025 — but researchers warn those costs are likely to weigh on the insurance premiums of everyday Americans.

The study follows a call to action by the nonpartisan Congressional Budget Office over the summer, which noted that the law "might not have the effects" experts anticipated. Whether Congress moves to amend the No Surprises Act in response to the Georgetown findings and the CBO's earlier warnings remains to be seen.