As the healthcare affordability crisis grows, consumers and their employers are demanding widespread action to rein in rising costs and reduce ambiguity around what healthcare services cost and why prices vary.
The financial stakes are significant for businesses and working families alike. According to KFF’s 2025 Employer Health Benefits Survey, average annual premiums for employer-sponsored family coverage reached $26,993, up 6% from the previous year. Workers contributed an average of $6,850 toward those premiums, leaving employers to cover over $20,000 per family per year – a substantial expense that puts pressure on both business and employees.
That pressure is only expected to intensify. Preliminary findings from Marsh’s 2026 National Survey of Employer-Sponsored Health Plans indicate that employers expect health benefit costs per employee to rise an average of 8.2% in 2027, even after planned cost-reduction measures. These increases can force businesses to make difficult choices about how to maintain affordable coverage while managing other expenses and investing in their workforce.
Recent federal actions offer a promising step toward addressing those concerns. On October 5, federal regulators announced measures to make healthcare pricing information more usable and strengthen accountability—developments that could help employers make more informed purchasing and contracting decisions as they work to provide competitive benefits and wages.
Making Healthcare Pricing Data Easier to Use
In a recent final rule, the Departments of Treasury, Labor, and Health and Human Services require health insurance companies to disclose prices of healthcare items and services while leaving out unnecessary data that makes it harder to digest for consumers and employers.
The rule, which amends the Transparency in Coverage (TiC) regulations first published in 2020, requires group health plans and insurers to take actions that will:
- Minimize duplicative and unnecessary information in healthcare pricing data;
- Provide necessary context about in- and out-of-network prices, reducing data ambiguity in return; and
- Strengthen accountability and increase accuracy of pricing disclosures.
Clearer healthcare pricing data can help employers compare negotiated rates, evaluate health plan networks, and negotiate better terms.
Research underscores that employers need this information to better understand their spending. RAND found that employers and commercial insurers in its study sample paid an average of 2.54 times what Medicare would have paid for hospital inpatient and outpatient services in 2022, with substantial price variation across states. However, many employers are not able to understand this in their own benefits spend.
These differences raise practical questions: How do the rates a given employer or their health plan negotiated compare with those paid by other purchasers? Are higher prices accompanied by better quality or access? More usable pricing data can help employers ask sharper questions of providers as well as their insurers and benefits partners — and assess whether their healthcare spending delivers value for employees.
Pairing Price Transparency with Accountability
Alongside efforts to improve insurers’ pricing disclosures, federal regulators are also scrutinizing how providers communicate prices to patients.
On the same day the TiC final rules were released, the Federal Trade Commission (FTC) issued letters to 24 major hospitals reiterating their legal obligation to provide timely, transparent pricing information to patients, specifically for routine and non-emergency medical care scheduled in advance. The letters warn that failure to disclose the price of a healthcare service may be deceptive if the omission is likely to mislead consumers.
They also make it clear that providers can still be held liable for unfair or deceptive pricing practices under the FTC Act even if they comply with other agencies’ existing price transparency requirements.
The move follows the Agency’s launch of a Healthcare Task Force earlier this year, which signaled increased attention on protecting patients and employers from deceptive and unfair pricing practices by providers.
Turning Better Data into Action on Affordability
While better data can help consumers shop for services and employers negotiate lower prices, it is only the beginning. Working families and businesses need more robust policy action to curb the rising healthcare costs straining benefits and wages.
Against that backdrop, the FTC’s letters and TiC updates add to bipartisan Congressional efforts — including the advancement of the Lower Costs, More Transparency Act of 2026 (H.R.9393) — to improve healthcare price transparency and strengthen accountability. Together, these efforts are steps toward helping employers and consumers navigate rising healthcare costs. But transparency alone is not enough. Employers need to use pricing data to negotiate better contracts, and policymakers must address the underlying policies and market practices driving up healthcare costs.
These federal actions offer a promising foundation, and sustained follow-through will determine how much they help employers and working families.