The national political arena has been consumed by the debate over the impending expiration of Obamacare subsidies.
However, some experts have suggested to the Daily Caller News Foundation that Republicans might be able to leverage the growing momentum around price transparency to help reduce healthcare costs for Americans.
The longest government shutdown in history was fueled by the Democrats' refusal to negotiate on the soon-to-be-expired Obamacare premium subsidies, which were passed in 2021 without Republican support and are set to expire at the end of 2025. Republicans are still formulating their healthcare proposal, including the possibility of supporting a limited extension of these subsidies.
According to the Daily Caller, even without a clear resolution on the subsidies, experts believe that more can be done to build on the healthcare-related measures already in place. This includes President Donald Trump's executive order issued in February, which directed agencies to implement "radical price transparency" and require the disclosure of actual healthcare service prices.
Supporters of the executive order argue that additional measures could help reduce costs by fostering competition and giving Americans more control over their healthcare expenses. "When Americans can see what they're actually paying for in health care, competition works. Costs fall, middlemen lose their grip, and Americans get control over this critical part of their lives," former House Speaker Newt Gingrich told the DCNF.
He added, "With President Trumps transparency platform already in motion, now is the perfect time for his administration and Congress to deliver real affordability through radical transparency.'"
Trump's executive order builds on a previous one he signed in 2019, which mandated hospitals and health plans to provide price estimates for certain services. Just before leaving office in 2021, he also signed the No Surprises Act, which prohibits surprise medical bills, requires providers to offer good-faith estimates of expected charges, and mandates insurers to send patients an advanced explanation of benefits (AEOB).
If fully implemented, price transparency regulations could result in annual healthcare savings of up to $80 billion, according to some estimates. "Price transparency will reveal prices that vary 10x within a hospital depending on a patients plan, drive competition, protect from overcharges and lower costs," Cynthia Fisher, founder and chair of PatientRightsAdvocate.org, told the DCNF. "Real prices will transform healthcare for the benefit of all patients, employers, workers, unions, and taxpayers."
However, the enforcement of the No Surprises Act stalled during the Biden administration, and the AEOB requirements have yet to be implemented nearly five years after the laws passage. Fisher recently wrote to the president, urging him to direct the Centers for Medicare & Medicaid Services to issue and enforce the AEOB rule, begin delivering pricing information in 2026, and ensure employers have access to data needed to negotiate lower costs for employees, among other recommendations. "By doing this, you will deliver a system in which patients, employees and unions not the insurance and healthcare industry fat cats hold the power," Fisher wrote.
Lawmakers have also proposed codifying price transparency rules. The bipartisan Patients Deserve Price Tags Act, introduced by Republican Sen. Roger Marshall of Kansas and Democrat Sen. John Hickenlooper of Colorado, would codify Trumps 2025 executive order and require machine-readable files of all negotiated rates and cash prices between plans and providers, and mandate that hospitals post actual prices for all services starting in 2026.
Healthcare is expected to be a pivotal issue in the upcoming midterms, according to a September Echelon Insights poll. By a nine-point margin, voters said they trust Democrats more than Republicans on healthcare. However, the poll found that if in 2026 Trump requires providers to give patients actual prices before care, 62% of respondents said they would support the presidents healthcare agenda. Furthermore, half of the respondents said they would be more likely to back a midterm candidate who helped Donald Trump deliver actual prices before care to patients.
Simultaneously, Republicans in Congress are formulating proposals to redirect Obamacare subsidies from insurers to consumers purchasing their own coverage. The GOP argues that such a shift would give individuals more control over their plans. The concept appears to have the backing of the president, who earlier in November called on Republicans in Congress to send dollars directly to Americans.
"The insurance companies are making a fortune. Their stock is up over 1,000% over a short period of time Why dont we just pay this money directly to the people of our country and let them buy their own health insurance?" the president said on Nov. 16.
"For decades, politicians have failed to stand up to medical industry executives who refuse to provide upfront prices to patients. Thankfully, those days are ending," Trent England, executive director of Save Our States, told the DCNF. "President Trump is pushing for transparency and accountability in health care. He has the power today to deliver real results for the American people."
However, with less than a month until the expiration of the subsidies, neither the president nor Republican leadership has endorsed an official proposal. Meanwhile, Democrats have made the impending expiration of enhanced ACA subsidies, along with broader Republican healthcare reforms, a top midterm attack line.
They warn that without an extension, premiums will surge for millions of Americans and thousands will die, framing any Republican opposition as an attempt to dismantle Obamacare.
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