Valued Voice

Price transparency in health care continues to be a hot topic on Capitol Hill. Following the House Ways & Means Committee vote last week to advance price transparency legislation, as covered in last week's edition of The Valued Voice, other Congressional committees are turning their attention to this issue.

On July 21, the House Energy and Commerce (E&C) Committee advanced the Lower Costs, More Transparency Act of 2026, legislation that would codify and expand federal price transparency requirements for hospitals, ambulatory surgical centers, laboratories, imaging providers, pharmacy benefit managers and health insurance plans, including health plan service providers and third-party administrators. Importantly, the health insurer transparency requirements include aspects from the Improving Seniors Timely Access to Care Act as well as other insurer transparency provisions, such as:

• Data on the use of prior authorization (PA), including lists of all items and services subject to PA, numbers and percentages of requests approved and denied, appeal overturn rates, response times, etc.
• Information on overhead costs and how premium revenue is spent on claims and non-claims alike.
• Additional transparency requirements on prior authorization, cost and encounter data for Medicare Advantage plans.

The committee also voted to advance the Prices on the Wall Act of 2026, which would require hospitals to post prices physically on the walls of hospitals beginning Jan. 1, 2028.

Meanwhile, on July 22, the Senate Health, Education, Labor, and Pensions (HELP) Committee voted to advance The Patients Deserve Price Tags Act, its version of health care price transparency. This bill is similar to the House E&C package, but without the Medicare Advantage and prior authorization requirements. It would codify and expand price transparency requirements for hospitals, ambulatory surgical centers, laboratories, imaging providers, pharmacy benefit managers and health insurance plans. Whereas the House legislation only requires hospitals to list prices for at least 300 shoppable services, the Senate legislation requires this for all shoppable services.

Senator Rand Paul was the lone Senator to vote against the package, saying, “I don’t want people to think that this [bill] fixes the problem. When you mandate transparency on prices that are fixed, it doesn't change the situation. The goal and what we need to try to strive to is where we have more patients that are in the situation where prices are fluctuating.”

WHA is continuing to follow these bills closely and has been in contact with Wisconsin's Congressional Delegation to let lawmakers know of the strong work hospitals have already done and continue to do to promote price transparency (see this week's column by WHA President & CEO Kyle O'Brien, which was shared with Wisconsin's Congressional Delegation). Given the variances in the different versions of the bill, it is unclear what path forward these packages have. Committees will likely continue to discuss these bills during the upcoming August recess, and it is possible the House and Senate could negotiate a package either before the election, or more likely, in a lame duck session after the election.