WASHINGTON, D.C. – For years, health insurance empires have been required under President Trump’s price transparency rules to publish the prices they negotiate with doctors and hospitals. Rather than make that information useful, they buried it in massive, difficult-to-navigate files. Patients have been forced to make health care decisions without knowing the costs they will have to pay or whether they are getting a fair deal. Under a final rule from the Trump Administration, insurers now have to make those prices easier for patients to find and certify that the published pricing data is true, accurate, and complete. The new Transparency in Coverage rule strengthens President Trump’s original price transparency framework, follows a year of Ways and Means Committee oversight of the nation’s largest health care empires, and advances reforms also reflected in in the Committee-passed Health Care Price Certainty for All Americans Act (H.R. 9645).
Ways and Means Committee Chairman Jason Smith (MO-08) released the following statement:
“Every day, hospitals and insurance companies negotiate the price of care behind closed doors and behind the backs of patients. The hospital knows the price. The insurance company knows the price. The only person who doesn’t is the patient, who finds out weeks later when a surprise bill shows up in the mailbox. President Trump took the first step to change that by requiring insurance companies to disclose prices that had long been hidden from patients. For years, insurers did the bare minimum of posting their prices but buried them in massive files no family could ever use. Over the past year, Ways and Means Republicans have worked alongside the Trump Administration to strengthen those reforms. We brought the CEOs of the nation’s largest health insurance empires before the Ways and Means Committee to answer for their hidden prices and skyrocketing health care costs, which have resulted in less access to services and worse quality of care. The Committee also passed legislation to write price transparency into law and put insurance executives on the hook for the accuracy of the prices they report. The new rule puts that shared work into action and delivers on President Trump’s Great Healthcare Plan. Insurers will finally have to show patients what care costs before they get it, not after, and do so in a way that is easy to understand. Republicans believe working families should be able to shop for health care the same way they shop for everything else. Every Democrat on our Committee voted against this effort to make price transparency more useful, choosing to protect and put the interests of the health care empires above those of working families. Republicans will keep working with President Trump to make these protections permanent and bring costs down for every American family.”
What the final rule does:
- Requires insurers to attest that their pricing data is true, accurate, and complete and to identify the senior executive responsible for this guarantee.
- Closes the loophole that let insurers report little or no information on what they pay out-of-network providers.
- Cuts junk data from pricing files, such as rates for podiatrists to perform heart surgery, and organizes prices around actual provider networks.
- Requires insurers to provide personalized cost estimates over the phone, in addition to online or on paper, and to post a standard “Price Transparency” link on their homepages.
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READ: Chairman Smith: A Great Health Care Plan for Patients, Not Special Interests