Challenge to Affordable Care Act negates recent move to increase price transparency

Although the Trump administration has after four years has finally done something that could actually help the nation’s healthcare system, what’s distressing are its continuing actions that stand to reverse any positive movement.

The administration last week issued a final a rule designed to enhance price transparency requirements for healthcare. This includes a mandate that some health plans make public the rates negotiated with medical providers included in the plan’s network.

Prices for drugs would also be made available.

If carried out successfully — certainly no guarantee under this administration — the rule in practice would give consumers a realistic view of what hospitals charge for various types of medical services. That’s sorely needed — and the type of transparency that writers of the Affordable Care Act (ACA) had in mind from the start a decade ago.

The rates that health insurance companies negotiate with doctors and medical facilities have always been closely held secrets. Casting a spotlight on these — as the rule is intended — could benefit consumers. They would know in advance what a particular procedure would cost. This would lead to providers competing on price and quality.

Most of the provisions included in the final rule are scheduled take effect on or after Jan. 1, 2022.

The rule is certainly a step in the right direction. The questions are:

· What took so long?

· Why did it come to light shortly before an election in which the administration is doing so much to weaken the ACA?

The American Hospital Association has already launched a challenge to the rule. And the CEO of America’s Health Insurance Plans (AHIP) issued a statement against the rule, saying it will drive up insurance costs.

Opposition to positive change is, unfortunately, not unexpected. What’s more distressing is the detrimental actions this administration has taken over the last four years to weaken the ACA.

Topping this list is the administration’s push to abolish the entire law. The challenge will be heard by the U.S. Supreme Court on Nov. 10. A rule to improve price transparency would be lost if tens of millions of citizens lose coverage and up to 130 million no longer have protection for preexisting medical conditions.

It would be devastating to Washington state as well.

A graphic of two boxes showing how Washingtonians benefit from the Affordable Care Act
What’s at stake in WA state if the ACA is overturned — Governor.wa.gov

All this during a raging pandemic the administration has cruelly ignored and done next to nothing to contain.

The rule put in place last week is welcome. But with everything else at stake and given this administration’s actions to weaken healthcare in so many other ways, it’s too little, too late.

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WA State Office of the Insurance Commissioner

WA State Office of the Insurance Commissioner

Washington state Insurance Commissioner Mike Kreidler regulates the insurance industry and protects insurance consumers.