States Realize the Importance of Price Transparency in Healthcare
Price transparency is more than a regulatory requirement; it is a growing movement that has the potential to change healthcare.
In recent years, the “price transparency in health care” movement has continued to gain momentum—a shift that has the potential to completely reshape the relationship between healthcare providers, patients, and payers. This year alone, Ohio, Oklahoma, and Nevada passed bills mirroring the ALEC Model Hospital Price Transparency Act. These critical policy wins showcase, once again, that states are leading the way with Essential Policy Solutions.
Before President Trump’s re-election in 2024, states began to pass hospital price transparency laws that allowed for state enforcement and penalties for non-compliance. These bills are essential as enforcement from Washington can change depending on who is in the White House, while state enforcement is permanent.
For decades, patients have navigated a system where costs are too often obscured until after services are provided, resulting in surprise bills and leaving an estimated 41% of Americans with medical debt. Thanks to a combination of technology, legislation, and consumer advocacy, that is changing.
The Affordable Care Act, which required hospitals to post standard charges, started the call for basic information about hospital pricing. Yet it wasn’t until President Donald Trump took office that it gained momentum. His executive order and the resulting Hospital Price Transparency Rule, mandated by the Centers for Medicare & Medicaid Services (CMS), require hospitals to publish standard charges for all services in a machine-readable file along with a consumer-friendly display of at least 300 shoppable services with prices.
Compliance by hospitals was remarkably slow. Early reports found many hospitals failed to meet the full requirements. Some failed due to incomplete data, some found data buried in hard-to-navigate interfaces, and others refused to comply. The election of President Joe Biden in 2020 delayed the enforcement of these rules, but President Trump made it clear when he was re-elected in 2024 that he intended to fix the problem. President Trump wasted no time in issuing another executive order directing federal agencies to update their enforcement policies and standardize pricing information, including the disclosure of real prices rather than estimates.
The momentum behind health care price transparency is real and growing. Patients, especially those with high-deductible health plans, increasingly demand transparency from providers. Employers are joining the movement, particularly large, self-insured employers who are leveraging transparency data to negotiate better rates and steer employees toward high-quality providers with the best prices. As technology progresses, healthcare comparison tools are becoming increasingly sophisticated, enabling users to compare prices across facilities for basic procedures such as MRIs and colonoscopies.
Price transparency is more than a regulatory requirement; it is a growing movement that has the potential to change healthcare and is one of the rare nonpartisan issues we can all agree on. Across the country, patients, employers, and government agencies are pushing for clarity and demanding compliance.