Trump administration warns more than 500 hospitals to provide more price information or face fines
WASHINGTON (AP) — The Trump administration has warned more than 500 hospitals that they are failing to provide the public with basic pricing information — arguing that the lack of disclosure is keeping healthcare costs higher than they should be.
The Associated Press obtained exclusively the list of hospitals that since April have either received letters of warning or, in more severe cases, requests to submit plans to provide transparent pricing. Failing to comply with the warnings comes with penalties as high as $2 million annually for each recipient that doesn't create a plan to post clear pricing data.
The letters are meant to fix a fundamental problem that patients, employers and insurers might not know ahead of time the cost of blood work, an imaging test or another form of treatment, and as a result pay more than they should have. AP has posted the list of hospitals that have received letters.
A senior administration official who requested anonymity to provide the list said that President Donald Trump plans to tighten enforcement of price transparency standards made possible by a 2019 executive order signed by Trump. More hospitals are likely to receive letters regarding the absence of pricing data, the official said.
The warnings are the latest example of Trump leaning into the message that his administration is fixing the problem of healthcare expenses that can drain a family budget. It's a calculated pitch ahead of the November midterms at a time when affordability is a top concern for voters. But Trump is also vulnerable on this particular issue, as his administration allowed subsidies to lapse for people buying insurance through the 2010 Affordable Care Act, widely known as Obamacare.
Just 29% of U.S. adults approved of Trump's healthcare policies according to the most recent survey on the issue by The Associated Press-NORC Center for Public Affairs Research. The president fared slightly worse on that issue in the December survey than on the economy, immigration or his management of the federal government.
Gary Claxton, senior vice president and the director of the program on the healthcare marketplace at KFF, said that the pricing data is more useful for benefit consultants and others in the sector with access to additional information than it would be for consumers. But he said that the standards in reporting pricing data can still create difficulty in making accurate comparisons about the costs and quality of the services being provided.
“There’s a pretty widespread belief that prices are more divergent than they should be in a competitive market — and this is one way of trying to understand that more," Claxton said. “It’s moving in the right direction, but that doesn’t mean it has gotten to where it needs to be.”
The push for price transparency could have a particular impact on Republican strongholds like Texas, Florida, Indiana, Alabama and Louisiana, which are among the states with the highest count of hospitals that have not provided adequate information on the costs of medical services.
Texas had 42 hospitals that received warnings, more than any other state. Baptist Medical Center in San Antonio, Texas, among the state's largest hospitals with 1,585 beds, received a letter, as did the University of Texas MD Anderson Cancer Center in Houston.
Missouri-based Ascension, one of the country’s largest hospital systems, had 13 hospitals in multiple states that received letters. The Republican state of Indiana had 34 hospitals that received letters, nearly as many as the 38 in Democratic-led California, even though California has five times more people than Indiana.
Administration officials interviewed for this article noted that Christiana Hospital in Biden's home state of Delaware also received a warning letter.
The letters reflect two competing philosophies between Republicans and Democrats over how to handle the ballooning expense of healthcare, which is also a growing risk for the federal government's own balance sheet.
Biden's team put more emphasis on record enrollment in Obamacare programs that increased the percentage of people with health insurance. Biden also signed a bill that allowed the government to begin negotiating prices for some Medicare drugs directly with pharmaceutical companies. That program, which has continued into Trump’s second administration, has helped knock down the list prices of some of Medicare’s costliest drugs.
The Trump administration, by contrast, has focused more on trying to find ways to provide details on pricing — such as promoting the TrumpRx site for prescription drugs — betting that doing so will lead to better and more efficient spending on healthcare as the data gets crunched.
Critics have said Trump's negotiated prices on prescription drugs might not produce genuine savings for many Americans with insurance, while the administration has estimated savings in excess of $500 billion over 10 years.
With the various lists of hospital prices, the administration wants providers to make it easier to access the files and to ensure the information in them is legitimate, instead of being based on estimates or omitting numbers for key procedures.
The House Committee on Energy and Commerce has a hearing planned for Wednesday on price transparency.
“Transparency is the foundation of a healthcare system that rewards competition based on cost and quality,” Shawn Gremminger, CEO of the National Alliance of Healthcare Purchaser Coalitions, plans to say in his prepared remarks.
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