Trump Administration Issues Healthcare Price Transparency Rules

The Trump administration has finalized new healthcare price transparency regulations in an effort to allow Americans more clarity about their medical costs. 

The rules, posted Oct. 5, strengthen the federal Transparency in Coverage (TiC) requirements that went into effect in 2022. The TiC required most insurance companies and employer health plans to post the prices they negotiate with doctors and hospitals. But some said those files were large and cluttered, so few employers or patients could navigate them. 

The new rules, finalized jointly by the U.S. Department of Health and Human Services, the Labor Department, and the Treasury Department, working with the Centers for Medicare & Medicaid Services, aim to “create a more transparent healthcare marketplace and also ensure employers can make more informed decisions; researchers can better understand healthcare markets; and innovators can build better tools,” the agencies said in a fact sheet. 

Toolkit: Essential Healthcare Cost Management Strategies 

The final rules improve the underlying healthcare pricing data by reducing duplicative and unnecessary information, providing more context about in-network prices, increasing available out-of-network pricing information, and strengthening accountability for the completeness and accuracy of published data, the agencies said. Reporting frequency for pricing information will change from monthly to quarterly, maintaining transparency while lowering administrative burden. 

The rules also require group health plans and health insurance issuers to provide consumers with personalized cost-sharing information by phone, in addition to existing online tools. 

“Greater transparency drives competition, reduces price disparities, and helps lower healthcare costs, a key priority for the Trump administration,” CMS Administrator Dr. Mehmet Oz said in a statement. “At the heart of this rule is a simple idea: People should know what their health insurance will cover and what they will need to pay before receiving medical care, not after the bill arrives.” 

Some proponents, including the ERISA Industry Committee (ERIC), said that the new rule will help employers lower healthcare costs. 

“Employers buy healthcare for their workers, and for too long the prices have been hidden or buried,” said James Gelfand, president and CEO of ERIC. “The first round of price data opened the books. This rule makes the data usable by a general audience. For large employers that provide coverage to tens of millions of workers and their families, better data means we can spot when one hospital charges more than another for the same procedure, negotiate harder, build better networks, and cut waste that drives up costs for employers and employees alike.”