A bipartisan group of lawmakers across three committees in the House of Representatives introduced a new measure on Friday aiming to secure price transparency for healthcare procedures and services.
“Our bipartisan legislation meets this moment by giving patients what they are rightfully demanding: the ability to get the right care, at the right time, at a price they know and can afford,” said House Energy and Commerce Committee Chairwoman Cathy McMorris Rodgers (R-WA). “It will lower costs by giving patients the health care price information they need to make the decisions that are best for them and their families — something 95 percent of Americans support.”
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The Lower Costs, More Transparency Act combines initiatives from the Energy and Commerce, Education and the Workforce, and Ways and Means committees to improve price transparency, support healthcare workers and community health centers, and increase access to data regarding fee structures.
A central provision of the legislation mandates that hospitals make publicly available a list of at least 300 services and list the prices for insurance-paid and cash-paying patients, which closely mirrors regulations established by former President Donald Trump in 2019.
In response to a lack of compliance with the Obamacare provision that hospitals must list prices of their standard services, the Trump administration issued regulations to require greater price transparency for consumers, stipulating that fees for hospital services must be made clearly accessible for patients to be able to compare costs between providers.
Even with these regulations, however, the Centers for Medicare and Medicaid Services are severely behind in enforcing compliance.
A 2022 analysis conducted by the advocacy group the Foundation for Government Accountability found that 63% of 6,400 hospitals examined were noncompliant with transparency regulation guidance. Similarly, a 2023 report from Patient Rights Advocate found that 75% of 2,000 hospitals surveyed did not meet existing federal standards.
“The Lower Costs, More Transparency Act will bring honesty and clarity to the cost of health care by requiring health insurers, hospitals, and PBM middlemen to be transparent about the prices they charge patients,” said Ways and Means Committee Chairman Jason Smith (R-MO). “It will increase access to care for patients by combating consolidation in health care delivery that drives up costs by shining a light on the increasingly common practice of vertical integration.”
The 231-page legislation also addresses the cost of prescription drugs by requiring pharmacy benefit managers to semiannually provide employers with data on prescription drug pricing, including hidden fees.
“Hidden fees, dishonest billing, and other harmful practices in the health care industry have left patients in the dark about the cost of care,” said Education and Workforce Committee Chairwoman Virginia Foxx (R-NC). “This good faith effort will allow patients to cut through the confusion in the health care marketplace and make informed decisions.”
The bill also aims to cut Medicaid spending by eliminating $7 billion from the Medicaid Improvement Fund and reducing waste in the pharmaceutical spending for the Medicaid program.
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At the same time, the bill also extends appropriations for several community health programs, including the Community Health Center Fund, the National Health Service Corps, and the Teaching Health Center Graduate Medical Education Program.
“This bill represents what our committees do at their best: work together to deliver bipartisan results for the American people,” said Energy and Commerce Committee ranking member Frank Pallone (D-NJ).
Investigative reporter Breccan Thies contributed to this report.
