Takeaways
- Employers who sponsor group health plans should review and revise, as needed, their consumer-facing pricing information for any compliance issues under the Executive Orders and applicable regulations.
Related Links
- Making America Healthy Again with Clear, Accurate, and Actionable Healthcare Pricing Information
- Fact Sheet: President Donald J. Trump Announces Actions to Make Healthcare Prices Transparent
- Executive Order 13877 – “Improving Price and Quality Transparency in American Healthcare to Put Patients First
- 45 C.F.R. Sections 147.210-212
Article
On February 25, 2025, President Trump signed “Making America Healthy Again with Clear, Accurate, and Actionable Healthcare Pricing Information,” an Executive Order with the stated purpose of making group health plans and health insurance issuers accountable for compliance with price transparency rules implemented during the first Trump administration.
Specifically, during his first administration, President Trump signed Executive Order 13877 – “Improving Price and Quality Transparency in American Healthcare to Put Patients First,” seeking to address what the new Executive Order describes as “opaque healthcare pricing arrangements” and insufficient accountability concerning healthcare pricing practices. Under Executive Order 13877, regulations were created requiring group health plans to:
- Post their negotiated rates with providers;
- Post out-of-network payments to providers;
- Post the actual prices the plan or its pharmacy benefits manager pays for prescription drugs; and
- Maintain a “customer-facing” internet tool through which individuals can access price information.
The new Executive Order referenced an unidentified 2023 economic analysis that estimated full implementation of the regulations might result in as much as $80 million in healthcare savings by 2025 for consumers, employers, and insurers. An unidentified 2024 report was also referenced for the proposition that price transparency could help employers reduce healthcare costs across 500 common healthcare services.
To address what was described as “stalled” progress on price transparency during the intervening administration, the new Executive Order gave the Secretaries of the Treasury, Labor, and Health and Human Services 90 days to act to:
- Instead of estimates, require the disclosure of actual prices of items and services;
- Ensure pricing information is standardized and easily comparable across health plans and hospitals by issuing updated guidance or proposed regulations; and
- Ensure compliance with transparency requirements by issuing guidance or proposed regulations updating enforcement policies.