Healthcare Price Transparency, Budgeting: Turmoil Continues

While we’ve obviously got some big news coming out of the U.S. Department of Health and Human Services (HHS), today I wanted to give you an update on a couple other big issues from the President’s desk and Capitol Hill.

President Trump signed an executive order (EO) last week aiming to support price transparency surrounding healthcare costs by reinforcing a transparency rule from his first term. 

This new EO requires the departments of the Treasury, Labor, and HHS to “rapidly implement and enforce” a 2019 Trump EO on price and quality transparency. Frequent readers may recall that this 2019 EO requires hospitals to publicly post standard charge information in a machine-readable format. Included in the new 2025 Trump EO is a directive to the agencies to develop a regulatory framework within the next 90 days to ensure the disclosure of actual prices of items and services (rather than estimates), issue updated guidance that ensures standardized and comparable pricing info across entities, and update enforcement policies.

Hospitals have reportedly been slow to comply with federal transparency rules. The latest study by Patient Rights Advocate.org found that only 21.1 percent of hospitals they reviewed were fully in compliance –  actually marking a steep decline from the previous report, in which almost 35 percent of hospitals were in compliance.

Hospital representatives have stated that this is often due to staffing issues and confusion regarding explicit requirements. But with President Trump’s renewed attention on the issue, it could soon become a priority for the administration – and the Centers for Medicare & Medicaid Services (CMS), as the agency has said it is planning more systematic monitoring and enforcement pursuant to the EO.

This could interact interestingly, however, with an EO the Trump Administration passed in January that states that for every new agency rule, regulation, or guidance, it must identify at least 10 existing documents to be repealed in order to promote the goal of its “regulatory reduction effort.” It is not clear if the departments implicated in the new transparency EO will comply with this “10-Out, 1-In” order, or if so, what rules and regulations they would cut in place of new transparency requirements.

Turning to Congress, they are currently in a stalemate after both chambers passed competing budget measures, and top members on both sides say they won’t accept the other chamber’s version. The Senate adopted a $340 billion budget resolution earlier in February, while the House passed its own version last week that was much broader.

President Trump has signaled his support for the House version, as it contains more items from his agenda than the Senate’s version, but both chambers must vote on the same budget resolution before they can formally draft a bill that can make it through the entire legislative process without issue or interference.

As my colleague Matthew Albright reported last week, the House budget resolution charged the House Energy and Commerce Committee with cutting $880 billion from the programs of which it is in charge.  Medicaid and Medicare are under the purview of this committee, and although Trump has said he will not make cuts to Medicare, Medicaid has not gotten the same promised protection. House Speaker Johnson has said that Medicaid is “hugely problematic” because of fraud, waste, and abuse, and Trump has given conflicting statements about its future. However, after the House resolution passed, Speaker Johnson went on record promising that the cuts would not come from policies directly impacting people’s Medicaid benefits or a change to the Federal Medical Assistance Percentage: the formula used to determine the federal government’s share of Medicaid and Children’s Health Insurance Program (CHIP) costs for each individual state.

These competing budget resolutions are also arising amid the looming partial government shutdown on March 14, and Speaker Johnson has stated that a stopgap measure holding federal funds at current levels is “becoming inevitable at this point,” given the fact that at least some Democrat votes would be needed on spending bills, and there is reportedly a tense dynamic over these bills, even among the GOP.