Bill introduced in House would increase health care pricing transparency, reduce costs

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A bipartisan bill designed to increase health care price transparency and lower costs for prescription drugs and health care services was introduced September 8 by the chairs of three House of Representatives committees with jurisdiction over health care.

Dubbed the “Lower Costs, More Transparency Act” the bill would, among other provisions, require health insurers and pharmacy benefit managers (PBMs) to disclose negotiated drug rebates and discounts, reduce out-of-pocket costs for seniors who receive medication at a hospital-owned outpatient facility or doctor’s office, and extend funding for research into diabetes treatments.

"Our bipartisan legislation…will lower costs by giving patients the health care price information they need to make the decisions that are best for them and their families—something 95% of Americans support,” Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-WA), one of the bill’s sponsors said in a news release.

Frank Pallone, Jr. (D-NJ), the committee’s ranking Democrat, added that the bill will increase funding for programs such as Community Health Centers and Teaching Health Center Graduate Medical Education. “This bill represents what our committees do at their best: work together to deliver bipartisan results for the American people,” Pallone said.

“Every day, Americans are forced to grapple with a health system that makes it nearly impossible to figure out the actual price for almost any type of treatment, medicine, drug, or procedure,” said Jason Smith (R-MO), chair of the House Ways and Means Committee. “Our response is simple: working families should not have to live at the mercy of large medical corporations who are too ashamed to list their prices publicly.”

“Hidden fees, dishonest billing, and other harmful practices in the health care industry have left patients in the dark about the cost of care,” said Virginia Foxx (R-NC), chair of the House Education and Workforce Committee. “This good faith effort will allow patients to cut through the confusion in the health care marketplace and make informed decisions.”

According to the release, the bill’s provisions fall into three categories:

Increasing price transparency system for patients

• Empowers patients and employers to shop for health care and make informed health care decisions by providing timely and accurate information about the cost of care, treatment, and services
• Requires hospitals, insurance companies, labs, imaging providers, and ambulatory surgical centers to publicly list the prices they charge patients, building upon the Trump administration price transparency rules
• Lowers costs for patients and employers by requiring health insurers and pharmacy benefit managers (PBMs) to disclose negotiated drug rebates and discounts, revealing the true costs of prescription drugs

Addressing the cost of presricription drugs

• Lowers out-of-pocket costs for seniors who receive medication at a hospital-owned outpatient facility or doctor’s office
• Expands access to more affordable generic drugs
• Equips employers with the drug price information they need to get the best deal possible for their employees

Supporting patients, health care workers, community health centers, and hospitals

• Funding Community Health Centers, which are crucial for patients in rural and underserved areas
• Supporting training programs for new doctors in communities
• Preserving Medicaid funding for hospitals that take care of uninsured and low-income patients
• Extending funding for research to find better treatments and a cure for diabetes, which affects more than 37 million Americans

Politico reports that the bill is expected to be voted on sometime this fall, perhaps as early as this month.