Congress’ critical opportunity to reshape health care

Passing some of these provisions could provide immediate benefits in affordability and transparency while laying the groundwork for future reforms

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By Jared Perkins and Chris Whaley

Dec. 2, 2024

Perkins is the director of Health Policy Strategy at the Center for Advancing Health Policy through Research (CAHPR) at the Brown University School of Public Health. Whaley is the associate director of CAHPR and associate professor of health, services, policy, and practice at the Brown University School of Public Health.

With the recent conclusion of the 2024 election, the spotlight now shifts back to Congress as it enters the final weeks of the 118th session. While time is limited and there is much to accomplish, Congress has a critical opportunity to reshape health care affordability, enhance transparency, reduce costs, and lay a strong foundation for future reforms through the Lower Costs, More Transparency Act (LCMT) and Health Care PRICE Transparency Act 2.0. Taking action on key provisions during the lame-duck session could serve as a catalyst for addressing issues such as health care consolidation, cost disparities, and opaque pricing structures before turning the page to a new legislative chapter.

One of the LCMT’s central provisions is to build on hospital and insurer price transparency rules enacted in 2019 and increase price transparency throughout the health care system. These initiatives are supported broadly by the people, economists, and members of Congress. According to a poll conducted in September 2024, 92% of likely electorate voters nationwide supported these requirements. There is also strong bipartisan, bicameral support for price transparency initiatives as the Senate is working with the Health Care PRICE Transparency Act 2.0 introduced by Sens. Mike Braun (R-IN) and Bernie Sanders (I-VT). Both bills expand on the already different transparency rules but in different ways.

Although the 2019 price transparency regulations were a good start, many hospitals have failed to comply. A recent report found that more than one- third of 100 hospitals reviewed did not properly post machine-readable pricing data. The LCMT and Health Care PRICE Transparency Act 2.0 would mandate that hospitals and insurers disclose real prices, including cash rates and negotiated insurance rates, codifying these rules into law. The legislation aims to improve compliance and make data clearer and more accessible for researchers, consumers, and employers. It also extends these requirements to clinical labs, ambulatory surgical centers, and imaging service providers in Medicare.

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