Price transparency alone is not a silver bullet, but it’s “a critical first step.”
It’s a holy grail of health care: forcing the industry to reveal prices negotiated between health plans and hospitals — information that had long been treated as a trade secret. And among the flurry of executive orders President Donald Trump signed during his first five weeks back in office was a promise to “Make America Healthy Again” by giving patients accurate health care prices.
The goal is to force hospitals and health insurance companies to make it easier for consumers to compare the actual prices of medical procedures and prescription drugs. Trump gave his administration until the end of May to come up with a standard and a mechanism to make sure the health care industry complies.
But Trump’s 2025 order is also a symbol of how little progress the country has made since he issued a similar directive nearly six years ago. Consumers find it only partially useful, and the quality of the information is spotty.A ‘Bold’ First Step That Fizzled
The 2019 order was “pretty bold,” said Gary Claxton, a senior vice president at KFF, a health information nonprofit that includes KFF Health News. “They basically went at the providers and the plans and said, ‘All this data you think is confidential we’re not going to make confidential anymore.’”
What followed was, to consumer advocacy groups, a disappointment. Hospitals and insurers posted on websites voluminous, complex, and confusing data about their prices. The information has been a challenge for even experts in health care pricing to navigate, let alone consumers. Some members of Congress filed legislation to put the force of law behind price transparency requirements; those bills died. And President Joe Biden’s administration was criticized for not more stringently enforcing the regulations, with one consumer advocacy group even buying a Super Bowl ad featuring the rapper Fat Joe alleging that “hospitals and insurers hide their prices.”
Trump’s new order, signed in February, said that hospitals and health plans “were not adequately held to account when their price transparency data was incomplete or not even posted at all.”
The Government Accountability Office reported in October that the Centers for Medicare & Medicaid Services didn’t know whether prices reported by the health care industry were correct or complete. But CMS, which regulates hospitals, now plans to “systematically monitor compliance” and help institutions understand the requirements, said Catherine Howden, an agency spokesperson.
Howden did not answer questions about whether CMS staffers overseeing price transparency compliance have been fired as part of the Trump administration’s wide-ranging effort to cut the federal workforce.‘Zombie’ Rates and Other Inconsistencies
Meanwhile, independent researchers have found numerous problems with the quality of price data both hospitals and health insurers do share with consumers.
A recent report from the Peterson-KFF Health System Tracker found that data reported by four health insurers in New York City often included prices that they say they pay hospitals for services that those health providers don’t — or can’t — provide.
