Pressure Senate to make health care prices transparent

Congress has considered how to make health care prices more transparent so Americans can better understand them. In December, the U.S. House passed the Lower Costs, More Transparency Act to achieve this.

Now, it's up to the U.S. Senate to make sure Americans reap the benefits of this legislation. Texans need Sens. John Cornyn and Ted Cruz to make sure this legislation passes before the March 8 federal budget deadline. When you buy something, whether gum or a house, a price tag tells you what it costs. But that's not true for health care.

Finding an accurate price for health care services is a monumental task usually involving digging through hospital websites for a billing code or description. If you find the service you're looking for, you may see a complex formula instead of a price, or a price drastically different from other hospital-provided estimates.

These unreliable estimates mean patients can't be sure what they'll pay. Even when people can choose a facility or doctor, hidden prices prevent them from making informed decisions about how to spend their money. No upfront price means no free market.

During the past decade, patients have started paying much higher shares of their medical bills compared with the amount their insurance companies pay. Unpredictable costs are going to affect Americans' financial wellbeing even if they have insurance.

A new bipartisan bill introduced by Sen. Mike Braun, Rind., and Sen. Bernie Sanders, I-VT., would change that. The so-called Health Care PRICE Transparency Act 2.0 would require hospitals to post prices in clear amounts, not formulas or estimates. This game changer would transcend current price transparency rules to ensure patients have the tools and information they need to understand their health care costs.

Just as the House did in its bipartisan price transparency legislation, the Senate must ensure that hospitals and the entire health care system comply with transparency requirements.

In Texas, less than one-third of the hospitals evaluated in an independent study were compliant with transparency rules. None of the 15 San Antonio hospitals surveyed in that study were fully compliant. None of the five local Methodist hospitals in the study provided the required range of prices for a service — a “negotiated” minimum, maximum or rate.

But monitoring and penalties for noncompliance are sparse and lack teeth. None of the noncompliant San Antonio hospitals are among the 14 hospitals that have been issued penalties nationwide. It's unclear whether they have been audited for compliance.

The Senate bill would require compliance reviews at least annually, not just sporadic audits. The bill requires senior hospital officials to attest that the hospital complies to the best of its ability and demands accountability for noncompliance.

The Senate faces a March 8 deadline to pass a federal budget, along with the price transparency bill. If it doesn't happen now, with attention turning to the campaign trail, we'll likely have to wait until after November.

Let's urge Cornyn and Cruz to make the most of this small window to prioritize health care price transparency and put pricing information into patients' hands.

Maribeth Guarino is Public Interest Research Group’s high value health care advocate. She helps educate lawmakers and the public about problems in health care and pushes for workable solutions.