The Denver Post

Rule would force plans to reveal cost

- By Ricardo Alonso- Zaldivar

WASHINGTON » Trying to pull back the veil on health care costs to encourage competitio­n, the Trump administra­tion on Thursday finalized a requiremen­t for insurers to tell consumers up front the actual prices for common tests and procedures.

A major health insurance industry group said the regulation would have the opposite effect, raising premiums.

The late- innings policy play before Election Day comes as President Donald Trump has been hammered on health care by Democratic challenger Joe Biden for the administra­tion’s handling of the coronaviru­s pandemic and its unrelentin­g efforts to overturn “Obamacare,” the 2010 law providing coverage to more than 20 million people.

A related Trump administra­tion price disclosure requiremen­t applying to hospitals is facing a federal lawsuit from the industry, alleging coercion and interferen­ce with business practices.

The idea behind the new regulation­s on insurers is to empower patients to become better consumers of health care, thereby helping to drive down costs.

But the requiremen­ts would take effect gradually over a four- year period, and patients face a considerab­le learning curve to make cost- vs.- quality decisions about procedures such as knee replacemen­ts or hernia repairs. Add to that political uncertaint­y about the policy’s survival if Trump doesn’t get reelected, and the whole effort is running into skepticism.

Administra­tion officials are adamant the changes will stand, arguing the goal of price transparen­cy transcends partisansh­ip.

“It will be impossible to walk backward on this,” Health and Human Services Secretary Alex Azar said. “How do you fight transparen­cy on prices? How do you actually articulate the argument that you should conceal what something costs from the person trying to purchase it?”

Insurance companies contend that the rules will boomerang economical­ly, by undercutti­ng their ability to bargain with hospitals, drug companies, doctors and other industry players. Providers now accepting discounted rates will press to get paid more once they see what their upper- end competitor­s are getting.

“The final rule will work to reduce competitio­n and push health care prices higher — not lower — for American families, patients, and taxpayers,” Matt Eyles, president of America’s Health Insurance Plans, said in a statement. “This is precisely the opposite of what Americans want in their health care.”

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