Skip to content

Chairman Smith Opening Statement – Hearing on Health Care Price Transparency: A Patient’s Right to Know

May 16, 2023

As prepared for delivery.

“Today, when a family faces a sudden illness, a chronic health issue, or a life-threatening accident their first thought is fear for the health of their loved one. Their second is to worry about how they will afford it.

“When concerned about their health, patients don’t want to be contestants on a game show trying to guess which hospital door leads to the lowest prices. Yet they frequently lack access to the price of a medical service before they receive it. Without greater price transparency, patients are in the passenger seat of their health care decisions. We want them to drive it.

“More than two years ago, President Trump signed into law the No Surprises Act, which contained consumer protections against surprise billing. It created a historically significant transparency tool for patients – an “advanced explanation of benefits,” or AEOB, to explain the costs associated with care before it ever takes place. And yet, so far the Administration has not implemented the AEOB program – keeping important information from patients and families. We remain hopeful that we can achieve our bipartisan goal of protecting patients.

“Why did Congress and the Trump Administration prioritize this effort? Because price transparency works. In the past 20 years, the prices of medical services increased by 130 percent. Meanwhile other shoppable commodities like TVs for example decreased by nearly 100 percent. Transparency and competition deliver better results. We have seen the price of shoppable health care services, such as Lasik eye surgery, decrease by 20 percent over 15 years, while innovation and quality have increased. That’s not a coincidence.

“Instead of keeping patients in the waiting room for real reform, we should pursue further price transparency tools to lower costs.

“According to one estimate, less than 25 percent of hospitals are fully compliant with President Trump’s historic price transparency rules – and those are just the ones reviewed. To date, the Centers for Medicare and Medicaid Services has only fined four hospitals for noncompliance. Four hospitals. There are 6,000 hospitals in the United States. Do we really think that nearly every American hospital is in compliance?

“We don’t know because CMS doesn’t make compliance reviews and enforcement actions public. You can get more information about a local restaurant from Yelp than you can get about your local hospital from CMS.

“Cash-strapped patients in dire situations need to be able to easily compare prices and decide for themselves where to get care. And lawmakers and innovators alike need to be able to see these trends with real data that will enable us to see where further reforms are needed.

“Americans want to know – and they have the right to know – what their health care will cost. Price transparency has support from all over. Just a few weeks ago I met with rapper, Fat Joe, to hear how he and his community are advocating for this very effort.

“Health care price transparency is crucial, but other reforms will also ensure patients can get better value for their dollars in health care. For example, tax-advantaged health accounts, such as Health Savings Accounts, allow patients to better save for medical expenses. When combined with true up-front knowledge of prices, this can be a powerful tool for families to plan and budget.

“Yet certain patient populations including working seniors on Medicare and service members and their families on Tricare are excluded from using HSAs. Outdated red tape prevents certain innovative health care delivery options for patients and employers using HSAs. We should make these types of accounts easier to use, not harder.

“A health emergency should not become a financial catastrophe. I’m looking forward to a bipartisan discussion on how to increase price transparency to strengthen our health care system and empower patients.”