Breakthrough Bipartisan Bill Revealed: Revolutionizing Health Care Costs and Transparency

A bipartisan health care bill aimed at enhancing price transparency, reducing prescription drug costs, and investing in the workforce has been introduced by House members from three key committees. The Lower Costs, More Transparency Act combines several legislative measures previously advanced by the respective panels, including the House Energy and Commerce, Ways and Means, and Education and the Workforce committees.

Representative Cathy McMorris Rodgers (R-Wash.), Chairwoman of the Energy and Commerce Committee, stated, “Our bipartisan legislation meets this moment by giving patients what they are rightfully demanding: the ability to get the right care, at the right time, at a price they know and can afford. It will lower costs by giving patients the health care price information they need to make the decisions that are best for them and their families — something 95 percent of Americans support.”

The bill incorporates provisions from the PATIENT Act, introduced in May, which requires hospitals to publicly disclose standard prices for all items and services in an easily understandable format. It also mandates upfront transparency on the cost of imaging services and laboratory testing, and requires pharmacy benefit managers (PBM) to provide spending data to employers.

To address concerns related to PBMs, the legislation includes measures to ban the practice of spread pricing in Medicaid. Spread pricing occurs when PBMs charge insurance providers more for medication than what they pay the pharmacy, resulting in a “spread” profit. PBMs contracted with Managed Care Organizations will be prohibited from engaging in spread pricing.

Representative Frank Pallone (D-N.J.), ranking member of the Energy and Commerce Committee, said, “This bill represents what our committees do at their best: work together to deliver bipartisan results for the American people. I’m grateful to my colleagues for partnering with me to strengthen the bill.”

In addition to price transparency initiatives, the bill includes funding extensions for the Community Health Center Fund, the National Health Service Corps, the Special Diabetes Program for research, and health workforce training programs.

However, the bill also proposes reductions of $7 billion from the Medicaid Improvement Fund, which aims to enhance Medicaid’s hospital and medical insurance provisions, as well as $8 billion over the next two years from Medicaid Disproportionate Share Hospital payments to hospitals serving Medicaid or uninsured populations.