← The Riley Gaines Show
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I want to share with you guys a video that I shared on x and on TikTok last week that went viral. Actually, I think on X right now it has over 12 million views. It was a video I made talking about hospital price transparency. Maybe rather than explaining it, I'll just play the clip here. I gave birth to this perfect, precious little angel in September of last year. It is April, nearly May of the next year, and I am getting bills in the mail nearly every single week. Let's look at them. Okay, this one is a bill for $2,000. The service description literally just says vaginal birth. Here's another bill for $1,261. What's the description for? Actually, it doesn't even say. Here's another one for $336. The service description is subsequent hospital care. What does that mean? Here's another $675 charge for hospital discharge day. What? What service is it? You're just charging me for discharge day? It says on this bill that our insurance information wasn't provided, but our insurance was provided on every other bill. I don't know. None of it makes sense. My husband just called. He was on the phone for 20 minutes and we got no answers. They said they could get back to us in the next 90 days. You have to assume that they just hope people pay these without asking any questions. Since President Trump has signed his executive order for hospital price transparency, only one third of hospitals are in compliance. President Trump has done what he can do. We need legislators to act to rein in these unchecked practices and to protect patients and taxpayers from a system designed to exploit them. The markups and the confusion are out of control. Margot turned seven months old last week, which, by the way, kind of sidebar here. It's so true. All the cliches, like, every stage is better than the last. Oh, my gosh, the stage she's at now, it's chaotic. It's busy. Like, she is so busy, she wants to pull everything. She wants to rip my hair, rip the necklaces, all the stuff on the planes. I made that video, a podcast, talking about, like, advice for first time moms or moms in General with a newborn on a plane. I thought I had it figured out. Let me tell you, she is a lot busier. Now. All you experienced moms, you could have told me this. All you seasoned moms, but it is so much fun. Even when we go to a restaurant and she, you know, there's glasses on the table or drinks and she pulls them down, which happens virtually every time we go to the restaurant, you can't help but just like smile and laugh because she really is so cute. Anyways, we had her seven months ago. We are still to this day receiving unexplained hospital bills in the mail. There is hardly ever an adequate description of the services. In the video I showed, they listed things as vaginal birth, discharge day, subsequent hospital care. What do these things even mean on these bills? There's no, like, phone number to call if you have any questions. It literally just gives you a QR code to pay online. It feels intentionally confusing and difficult, if not impossible, to get answers. Maybe if I told them I was in illegal, it would all be free. I posted this because really we want price transparency. And I say we because I imagine. Well, actually, I know for certain now that I'm not really just speaking for myself when I say this. I recognize the platform that I have that millions of people who follow me on X, on TikTok, on Instagram, the ability, a unique ability to be able to reach people in and influential positions, people in Congress, the House, the Senate, at both at the federal level, in states across the nation who can actually do something about this. I found in posting this, as I said, I know it's not just me. I found so many of you, so many people, moms, other people who visited hospitals for, you know, emergency services, whatever it is, even routine visits, who shared with me similar experiences. I'll read you a few. This guy here says he says, a year ago my wife went to the hospital for stomach pain. They did a CDC CT scan of her abdomen. Thankfully, didn't find anything serious. Even still, they got a bill in the mail of $9,117.42. He said he spent months talking to insurance hospitals, billing appeals. He was told that the claim was still in process. The claim was out of the normal service area. He was told that it wasn't clear it was medically necessary or that insurance wasn't valid on the date of service. He says they finally got it handled, but it took well over six months from the day of the first bill to the day they finished the process and paid. He says we did everything right. We have insurance, we pay our insanely high premiums every single month. It just so frustrating. Okay, in the vein of being fully transparent with you guys, we have I think United Healthcare now, but at the time we give birth to Margot, we had Blue Cross, Blue Shield. Do you know what we pay Louie and myself because we're both technically self employed, Meaning that I guess technically we're independently contracted by our employers. Louie has his own construction company. I work for several different companies. One of those being Fox or Outkick where you're streaming this podcast. But we're independently contracted, self employed, if you will. Do you want to know what we pay for three people, two self employed adults and a baby, Which I will say we don't use any of the amenities or resources for Margo because we had an impossible time finding a pediatrician who would accept us because she wasn't vaccinated. So we have to pay $175 a month for the pediatrician that we found because they wouldn't take our insurance. Besides the point, do you want to know what we pay? It is nearly $1,900 every single month. That is absolutely ridiculous. I actually don't know how normal people afford that. Look, I recognize that I'm in a position where both with the opportunities and career path that I'm on and of course my husband having his own business that we're able to guess what, it's still not comfortable paying $1,900 a month for health insurance as 26 year old human beings. That is absurd. Normal people cannot afford that. They cannot do that. Now granted, we have maternity care because I want to get pregnant again. We want to have more babies. Even still, that is insane. So you pay nineteen hundred dollars a month for insurance and even still you're getting billed $2,000, $1,200, $600, $300 here, there, everywhere. Every week we get these bills to our house. I'll read you a few more comments. This person says, my husband was very sick in 2023. We had HMO coverage and went to an in network hospital. They sent us to an out of network facility for critical tests and procedures. All required insurance pre approval delaying his care by weeks. He died without the treatment he needed. We are far too advanced as a nation to be dealing with these problems. Here's another person says, broke my wrist, went to the ER, X ray, splint, pain shot and Zofran 1 Zofran $7,000 cash pay, 40% discount surgery yesterday. Cash pay discount again. Okay. That's another thing that makes zero sense to me. You're telling me that if I don't like the price of the procedure or the service with insurance, I can go in and basically negotiate with the hospital if I pay cash. Like, who sets the price? Who's setting that price that they're not willing to go lower than? Right. Like, it just doesn't make sense. And he's right. Oftentimes they'll negotiate it 40, 50% lower than what they were charging you. So that right there feels like an admittance. That right there proves that they are way overcharging us. I could read to you for hours. Experiences and stories that came rolling in in the comments and people who direct message me another comment that I got a lot were people who were saying, you know, oh no, the leopard is eating your face, or people pretending that this only is happening because President Trump is in the Oval Office. Right. Shocker. These are people who are riddled with tds. Confused again. Are you trying to say that hospitals weren't expensive before? Hospital bills were expensive before Trump. They were expensive under Biden. They were expensive under Obama. The root cause actually traces straight back to the Affordable Care act, aka Obamacare, signed in 2010, fully implemented in 2014. That law, it didn't bend the cost curve down. It bent it up for millions of families in the individual and small group markets. You want the data? To all you people who are saying, you know, you get what you voted for, here's the data. If you want the actual data in the individual insurance market, which is the one that most people who are buying their own plans have to deal with, premiums more than doubled between 2013 and 2017. And who was the president during that timeframe? Yes, of course, it's Obama. An average 105% spike right after ACA or Obamacare rules kicked in. By 2019, they were up 151%. And deductibles, guess what? They exploded too. Your average silver plan deductible went from about 2,400 in 2014 to over 5,300 today. In most cases, families saw out of pocket costs for a plan for four jumped by more than $10,000 annually in some reports. And why? Why is this? Guess why. It's because Obamacare forced insurers to cover essential health benefits, many of which you never even use. They also banned charging based on pre existing conditions or real risk. They also imposed age rating limits that made healthy people like me subsidize everyone else. That created adverse selection, meaning sicker higher cost people flooded the pools while younger healthy people bailed or they paid way more insurers, they responded with massive premium hikes to stay solvent. It's basic economics here. Narrow network, surprise billing, hospital consolidation. All this followed because the law distorted the market instead of actually fixing it. So pre Obamacare, yes, costs were rising, right? Aging population, new technology, innovation all the time in the medical field, chronic disease. But the individual market, it hadn't seen these kinds of force jumps hosts Obamacare studies from places like the Heritage foundation, which yes, is a conservative organization, but actually even some left leaning analyses confirmed the individual market premium explosion was directly tied to Obamacare and to the law's mandates. And the billing opacity that I showed you guys in my video, that's the insurance, hospital insurer, three way dance on steroids. Obamacare push more people into plans with higher deductibles and confusing allowed amounts. While hospital learned that they could bill charge master rates, they could negotiate secretly with insurers and they could send patients the confusing scraps. That's what I showed in that video. That means no real price shopping. It means no competition. It means no transparency. It means you just pay with the QR code or it goes to collections and your credit is just ruined.
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All right, I want to talk to
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you guys about something that I know
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a lot of people privately and quietly deal with, which is private student loan debt. You've probably heard me mention my friends at Y Refi before. What they do is truly incredible. If you are stuck with private student loan debt, that feels impossible, or your monthly payment is higher than what you can afford, or maybe you're already in default, know that it does not have to be that way. And why Refi is here to help you. They work specifically with you, with people like you, one on one, they sit down to create a custom payment plan based on what you can actually afford. And the best part is they do not care about your credit score. So if this is something that could
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help you, help you feel like there
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was light at the end of the
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tunnel, you don't want to be weighed
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down by this burden anymore. Go to yrefi.com that is yrefy.com and be sure you tell them that Riley from the Riley Gaines show sent you.
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Now contrast that the ACA Affordable Care act or Obamacare with what President Trump has actually done, what he is continuing to do in his first term. He signed the executive order that required hospitals to post real prices. These are machine readable files for every service and consumer friendly Displays for shoppable ones like birth or MRIs or X rays and deliveries. He reinforced it again this year, actually, with a new order demanding actual prices, not even estimates, real prices. That is standardization, so that you, the patient can compare. My video mentioned it. Only one third of hospitals are fully compliant with this order. That's on the hospitals dragging their feet and previous administrations for not cracking the whip hard enough. It is not on President Trump for ignoring the problem. He is doing what he can do. As I said, we still need Congress to act just to wrap this up because again, it went viral online. I felt like I could further unpack it here and address some of the the leopard ate your face claims. We are still getting bills from the delivery in September of 2025 because of the system that Obama created, Obamacare. It's a system that rewards confusion over clarity. That is not what President Trump is doing. His approach empowers patients to shop. It empowers patients to compare and to hold providers accountable. Not to mention protecting the taxpayer. You and me.
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President Trump very clearly inherited a broken system. He is pushing the exact transparency that my family and millions of yours I would imagine desperately needs and wants. So if you want lower bills, I would encourage you to support enforcing price transparency and increasing competition and repealing the ACA's worst mandates, not doubling down on the law that supercharged all Okay, I want to hear Yalls hospital bill horror story. Drop it in the comments below. Actually it be super helpful for me in having those conversations with legislators if you want to like even leave the name of your representative below. This is something that I can hand deliver and show them that it's affecting their constituents. We are sick of paying blindly. At least I know I am. I want price transparency. I want a better healthcare system. America is the most advanced technologically. We are the most innovative nation in the entire world. We should certainly have a system that reflects that. Thank you guys for watching the Riley Gaines Show. You can subscribe right here. We have new episodes every single Tuesday and Friday at 10:00am Eastern Time and we are covering everything from pop culture to politics to deep dives to motherhood, sports, all of that and more. We want to hear from you though. What is it that you want to hear? Comment down below. We can't wait to see you next time.
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I've coached the game, I've played the game. So when I break it down on don't me, you're getting more than opinions, you're getting experience. We've put really dumb racist people on the air. That's the ESPN model right now. This show is about winning, accountability and truth, not the usual nonsensical soft takes. If you want real analysis from someone who's been there, join me. Search don't me on Spotify or Apple Podcasts. Subscribe right now. It's free, it's portable, and most importantly, it's as real as it gets.