Via Kaiser, the State of New York's Department of Financial Services issued a report on 'surprise' medical bills affecting people who have insurance. The consequences of such bills can be profound. There is too much good material in the DFS study to pass on through quotes so I urge you to read it yourself.
What struck me about the study is that it's the first one I've seen that tries to get into the nitty gritty interactions between patients, insurers, and providers that actually determine what people pay. The description of doctor "run-ins", where an out of network physician gets involved in a procedure without the patient's knowledge or consent really hit home, in a personal, "hey I got f$@#$! by a doctor just like that!" kind of way. The same goes for the inadequate notice on what providers are in or out of network. For my family and I suspect lots of people, seeing an out of network physician amounts to going uninsured. We try pretty hard to avoid that, but neither providers nor insurers make it easy.
Health care reformers tend to blow past this stuff because it doesn't offer that much in savings in the big picture, and it is a problem for people with insurance who by virtue of that alone are already a lot better off than those without. But addressing these problems, problems that people will recognize and react to, is a great way to build political support for reform. I hope those working on the state exchanges are paying attention because I think this will be a pass/fail test. Address problems that bother people and you get the laurels, ignore them and all the rocks people now throw at insurance are going to be heading your way.