For employers and working families, healthcare affordability is no longer an abstract policy debate. It shows up in rising premiums, larger out-of-pocket bills, and increasingly difficult decisions about how to keep coverage within reach.
That reality was front and center at last week’s House Energy and Commerce Health Subcommittee hearing on healthcare transparency. Lawmakers from both parties and expert witnesses struck a clear note: employers and patients are being asked to pay more in a system where prices are too often hidden, inconsistent, or impossible to compare.
Lack of transparency hampers employers’ ability to negotiate lower prices
As Rep. Nick Langworthy (R-NY) put it:
“In every other part of our economy consumers see the price before a purchase. Healthcare should be no different.”
That basic expectation remains unmet in most cases. While hospitals are required to disclose prices, that information is often buried, hard to interpret, or presented in formats that employers and consumers cannot easily use — and more than 75% of hospitals are not even compliant with price transparency regulations.
Rep. John James (R-MI) captured the frustration bluntly:
“Hospital prices are confusing and hard to find. The system is too complicated by design — it’s a confuse-opoly.”
That confusion has real consequences. RAND’s latest hospital pricing research found that employers and private insurers paid hospitals an average of 254% of what Medicare would have paid for the same services. Wide variation in prices across states, markets, and hospitals shows exactly why transparency matters: opacity weakens employers’ ability to negotiate and leaves workers and families paying more.
Rep. Frank Pallone (D-NJ) made this connection directly:
“A lack of transparency into healthcare prices… makes it challenging for employers to negotiate more competitive prices.”
That need is growing more urgent as families absorb more of the cost. Rep. Gus Bilirakis (R-FL) noted:
Employers are among the largest purchasers of healthcare in the country, yet even well-resourced purchasers cannot hold a system accountable without reliable information.
“Every year, families face higher deductibles and out-of-pocket costs, while employers struggle to keep coverage affordable for their workers.”
When prices rise faster than employers and families can absorb, businesses seeking to support their workers are forced to make difficult tradeoffs that can cause financial stress.
Transparency must extend beyond prices
The hearing also made clear that transparency cannot stop at posted prices. Lawmakers raised concerns about how consolidation, private equity ownership, and opaque payment arrangements drive costs while limiting accountability.
Rep. Lori Trahan (D-MA) was direct:
“The collapse of Steward Health left communities holding the bag… [and] private equity’s business model is to extract value, not deliver care.”
Research supports that concern: hospital acquisition of physician practices is associated with higher spending and prices, generally without evidence of improved quality.
The same logic applies to the 340B Drug Pricing Program. Rep. Jake Auchincloss (D-MA) noted:
“We’re talking about transparency and simplicity as an important element of healthcare, so I’ve got to talk about 340B — which is the least transparent and least simple part of our drug pricing system.”
Shawn Gremminger, President and CEO of the National Alliance of Healthcare Purchaser Coalitions, also called out the 340B program during his testimony, highlighting that:
“We have almost no ability to understand the degree to which 340B is impacting us. When a drug is sold through 340B we miss out on the rebates and discounts that we would otherwise get, this cost is significant and almost impossible to track.”
HRSA reports that covered entities purchased $81.4 billion in outpatient drugs through the 340B program in 2024, while the strongest state-level data — from Minnesota — indicates that employers and commercial plans finance nearly half (45.1%) of the program’s net revenue. As the program grows, employers and policymakers need clearer information about how discounts are used, whether savings reach patients, and how the program affects commercial costs.
Transparency is the foundation of reducing costs
Without reliable data and clear prices, employers cannot negotiate effectively, and policymakers cannot identify where market power is driving excessive costs— leaving workers and families paying more without knowing why.
Shawn Gremminger also spoke to this during his testimony:
“Transparency is necessary but not sufficient. This committee should also pursue site-neutral payment policies, restrictions on facility fees, and probations on anti-competitive contracting that lock employers into overpriced networks.”
Transparency provides the information needed to see where the system is failing, but that information must be paired with policy action to address the practices that keep prices artificially high.
Policymakers at the state and federal levels should build on this bipartisan momentum to advance reforms that make healthcare prices clear and comparable, and give employers, patients, and working families the information they need to demand accountability for their healthcare dollars.