This might concern people initially (because the discounts are currently so high) but for practical reasons after the ban is in effect the costs will go back to more or less pre-ban levels, but now simplify billing (reducing costs) and benefit people without insurance (no more absurd inflated bills).
Insurance discounts themselves are problematic, and also result in this silly "in-network" "out-of-network" system we have. In particular where you could go to an "in-network" hospital but get an "out-of-network" anesthesiologist or lab giving you care without warning.
Whether full coverage should be something the government works on as policy and whether subsidized private insurance is the best way to get to full coverage are different questions, but the most talked about parts of the ACA directly address people in that insurance gap.
I've used the high deductible plus HSA approach since it was an option. I don't know if this varies by state or plan, but all I ever pay is what the insurance company considers allowable.
Why is this concept ever even deemed acceptable? Why do you get the privilege of "only paying what the insurance company deems allowable, minus what they cover", but someone else has to pay in full?
This puts you in a state where you basically require insurance to get care at a reasonable price. Where its cheaper to have coverage and pay out of pocket, than to pay out of pocket without coverage.
This "negotiation" you mention works 1. If you know the price up front 2. have the leverage to negotiate.
And guess what, you have neither of them. This law changes one of those, so that shopping around is at least possible.
Aside: I'm surprised a lawyer didn't sue a hospital over Informed Consent via no billing knowledge.
In emergency situations this is hard to do, but I've done it numerous times when needing non-emergency health care. I even call around asking about prices and the cash discount. Oddly enough, a co-worker and I both had the same procedure (back issues ugh) last year at the same doctor. He used his insurance, and I asked about and went the cash route. I ended up paying less for the exact same thing because of how his deductibles worked.
It was the end of the year and I guessed I would not hit my yearly deductible so paying cash was the right move.
When I had knee surgery years ago, and had good insurance at the time, I asked the doctor about the price just to see. He was quick to say if I wanted/needed to pay cash he could work something out.
So they are out there, but you might have to do some digging.
And again, emergency situations are a completely different beast.
If you don't know the bill, they can't tell you the bill, and they have no way to get the bill until weeks later, how can they "negotiate" when nobody knows?
Frankly, that claim sounds like a pile of you-know-what. My bet is they take your money, and then bill you for the rest.
If you're serious about learning, stop listening to these people (seriously, it's a waste of your one precious life) and try taking a healthcare economics class or reading Paul Starr's Social Transformation of American Medicine.
Which means that anyone those insurer contracts don't cover, is getting royally screwed. Thus, healthcare is simply unaffordable to someone who doesn't have those insurers acting as a payment intermediary.
This one of the dirty secrets of the whole US healthcare coverage problem that I never see politicians (or talking heads) on either side actually acknowledging.