For many Americans, one of the most frustrating aspects of healthcare is not knowing what a medical service will cost until long after treatment has been completed. Unlike most industries, where consumers can compare prices before making a purchase, healthcare pricing has traditionally been difficult to access and understand. As lawmakers continue to debate reforms, advocates argue that greater price transparency could help patients make more informed decisions while reducing overall healthcare spending.
In July, the House Energy and Commerce Committee advanced healthcare price transparency legislation that could give patients and employers greater access to upfront healthcare prices. The legislation now moves forward for further consideration and could give patients and employers more information to help them avoid overcharges and choose more affordable healthcare.
Are the New Guidelines Transparent?
However, some advocates argue the proposed legislation may not go far enough. In a recent article for The Hill, Vivian Ho argues that the proposed legislation largely codifies the status quo and may be insufficient to achieve meaningful price transparency.
Ho points to her own research as evidence of the problem. After cross-referencing healthcare bills with posted insurance prices, she found that an exact or close price match occurred only 20.5% of the time, suggesting that posted prices often do not match what patients ultimately pay.
Ho explains that the legislation could be strengthened if lawmakers incorporated bipartisan elements from the Patients Deserve Price Tags Act. The Act, which was featured in a 2025 Senate Health, Education, Labor, and Pensions (HELP) Committee Member Day hearing is aimed at expanding existing federal reporting for hospitals and health insurers to ‘provide consumers with clear, concise information on the costs of health care items and services, and increase data accessibility for plan sponsors.’ It was designed to align with other healthcare price transparency legislation that is already in place.
Changes That Could Make a Real Change
The Hill article also breaks down elements of the Patients Deserve Price Tags Act that could be strengthen the pending legislation to allow for real change:
These requirements include demanding all providers and insurers publish monthly price disclosures, including negotiated rates, for all services, with senior health executives’ attestation of accuracy and strong penalties for noncompliance.
Legislators must also require hospitals and insurers to give consumers the tools needed to make sense of these price disclosures, which are too often disclosed as formulas, algorithms, or fee schedules, so they can make accurate comparisons. Finally, they should require hospitals and other providers to give itemized bills so consumers can compare them with posted prices to detect overcharges, double-billing, errors, or fraud.
Ho argues that, by incorporating these items into the current legislation, Congress could help patients overcome information gaps that can make it difficult to make informed healthcare decisions. With more accurate and accessible pricing information, patients could more easily compare prices and determine whether their final bills align with posted costs.
Solidarity is Committed to Affordable Care for Our Members
At Solidarity HealthShare, we are committed to providing our Members with affordable healthcare with no hidden costs. To keep our costs competitive and affordable, we use a Reference-Based Pricing model based on Medicare reimbursement rates. This approach ensures providers are paid fairly while keeping eligible medical expenses as low as possible.
To offer our Members additional access to savings, we provide a Solidarity Care Card that offers discounts on dental and vision care. For more information about joining the Solidarity community, please contact our Member Care team today at 737-SHARING or check prices online.