How forcefully did the No Surprises Act target costs? Not quite as much as employers and insurers had hoped, said Thomas Greaney, a visiting professor of law at the University of California, Hastings. Instead of setting benchmark rates for doctors’ services, the law allowed doctors and plans to go into arbitration to determine final payments.

“I think the decision to go with arbitration rather than benchmarks certainly gives a lot more flexibility and breathing room for the providers in terms of what the ultimate payouts look like,” Greaney said.

The arbitration approach thus renders the long-term cost impact of the No Surprises Act on health plans more uncertain than it might have been with the benchmarking approach, he said.