Comparing the House and Senate Price Transparency in Healthcare Bill | American Enterprise Institute

As the end of the 119th Congress comes into view, key House and Senate committees are making plans for what might turn out to be a busy work period either immediately before or after the midterm elections. Among the priority bills the health committees are readying are those addressing healthcare price transparency requirements. Passage of the strongest possible, and therefore also consumer-facing, version of this emerging effort would be a good step forward for American healthcare. Based on the bills now advancing, there is room for further improvement.

The outline of what Congress is currently considering, with broad support in both parties, has been visible for some time and is reflected in the similar but not identical approaches taken to date in the two chambers. In the House, the Energy and Commerce Committee voted unanimously to advance H.R. 9393, the Lower Costs, More Transparency Act of 2026. In the Senate, the Health, Education, Labor, and Pensions (HELP) Committee approved S. 2355, the Patients Deserve Price Tags Act, by a vote of 21 to 1. 

Table 1, which is based on useful summaries posted online by a private firm in the case of the House bill and by the HELP committee for the Senate version, provides a high-level comparison of the main provisions of the competing measures alongside what is required by current federal regulations. 

The approach taken on both sides of the Capitol is to use the existing regulatory requirements as the starting point for what would be codified in federal law and then to make changes to correct identified deficiencies and fill in gaps in disclosed pricing. 

A major focus in both bills is on stronger enforcement tools. Some service providers see the transparency push as a costly political gesture that needs to be managed rather than embraced. This lack of enthusiasm has translated directly into cumbersome datasets filled with millions of lines of useless information. The emerging bills would take care of this problem by writing into federal law more precise disclosure terms and also meaningful penalties for persistent stonewalling.

To close gaps in the prices available in the market, both bills also would extend the disclosure framework to ambulatory surgical centers (ASCs), imaging centers, diagnostic labs, and the prescription drugs covered by insurance plans. These are service and product categories with significant room for patient discretion, and thus should be good candidates for more vigorous price competition. The House bill also imposes new reporting and transparency requirements on pharmaceutical benefit managers (PBMs).

The toughest challenge continues to be translating disclosed prices into information consumers, as opposed to employers, are incentivized to use to secure lower-priced services. It is often argued by insurers that the only prices that matter to patients are the cost-sharing amounts owed when getting care. It follows, they continue, that transparency should focus on helping patients see what they would pay after insurance has covered some of the costs. The provision in the Senate bill which forces providers to stick with the prices given to patients in Advanced Explanation of Benefits (AEOBs), with some exceptions, is an attempt to build off of the concern patients have around cost-sharing.

While patients certainly do worry about their out-of-pocket costs after insurance coverage, total prices are also important because they affect premiums, and high premiums for employer coverage translate directly into lower wages for workers.

Two additions to a final House-Senate compromise plan would sharpen the focus on helping consumers secure lower-priced care and not just lower cost-sharing.

First, Congress should authorize the executive branch to require pricing from all relevant providers, including physicians, for standardized definitions of high-volume clinical bundles. It is one thing to have access to prices for small dollar lab tests, office visits, or imaging services. It is another altogether if patients had ready access to prices for full apples-to-apples episode bundles, such as for hip replacement surgery, with nothing left out and no need for legwork on their part.

Second, Congress should allow patients to break free from their insurers and select lower-priced options whenever possible (some states are exploring similar “Right to Save” ideas). For instance, if an insurer’s in-network rate for an MRI is $2,000 while a local imaging center charges $500, patients should be allowed to benefit financially when choosing the imaging center over the hospital even if their insurers would fully pay for the hospital-based service (patients are often price insensitive after satisfying their deductibles). Taking this step would incentivize independent suppliers to lower their prices by enlarging their pools of potential customers.

Currently, forced price transparency has bipartisan support, but there is no guarantee it will be a priority in the future. If the door opens to passing a new bill later this year, it will be important to make full use of the opportunity.  

Table 1. Comparison of Existing and Proposed Healthcare Price Transparency Requirements