President Donald Trump has signed an executive order to enforce hospital and insurer price transparency rules first introduced in 2019. He claims the Biden administration weakened these regulations and is now directing federal agencies to strengthen enforcement.
The executive order, signed Wednesday, calls on the Departments of the Treasury, Labor, and Health and Human Services (HHS) to ensure that hospitals and insurance companies disclose actual healthcare prices rather than estimates.
The goal is to give patients the ability to compare costs across hospitals and insurers, including for prescription drugs. The Trump administration contends that hidden prices have allowed large corporations to profit at the expense of American patients.
“When healthcare prices are hidden, large corporate entities like hospitals and insurance companies benefit at the expense of American patients,” the White House said in a statement. “Price transparency will lower healthcare prices and help patients and employers get the best deal on healthcare.”
Trump’s initial push for healthcare price transparency began in June 2019, when he issued an executive order requiring hospitals to disclose the real prices patients and insurers pay for services.
The rule went into effect on January 1, 2021, mandating that hospitals post a publicly accessible file with standard charges for all items and services, as well as a price estimator tool for at least 300 shoppable services. A companion rule required insurers to provide real-time cost-sharing information starting in July 2022.
Despite these requirements, hospital compliance has remained low. A 2023 report from Patient Rights Advocate found that only 24.5% of hospitals were fully adhering to the rule, even two years after it was implemented.
A more recent report from November 2024 showed an even steeper decline, with just 21.1% of hospitals meeting the full requirements. According to the report, many hospitals failed to provide clear pricing data, instead posting estimates or averages rather than real prices.
The Biden administration took steps to penalize hospitals that failed to comply, increasing financial penalties beginning in 2022. Under the revised rules, hospitals with more than 30 beds could face fines of up to $5,500 per day if they did not properly disclose prices. However, the latest compliance data suggests that many hospitals continue to avoid full transparency.
Trump’s new executive order directs federal agencies to step up enforcement efforts and ensure that pricing information is standardized. It also emphasizes the need to hold hospitals and insurers accountable for noncompliance, with updated policies to ensure prices are clearly associated with specific insurance plans.
“Hospitals and health plans were not adequately held to account when their price transparency data was incomplete or not even posted at all,” Trump wrote in the order. “The Biden Administration failed to take sufficient steps to fully enforce my Administration’s requirement that would end the opaque nature of drug prices by ensuring health plans publicly post the true prices they pay for prescription drugs.”
The American Hospital Association estimates that around 70% of hospitals have made efforts to comply with transparency rules, and a 2023 report from consulting firm EY found that commercial insurers comply at a rate of 94%. However, critics argue that many hospitals continue to skirt full compliance, leaving patients without the clear cost information they were promised.
Trump’s order reinforces the requirement that hospitals and insurers disclose actual prices, not estimates, and aims to provide patients with the tools needed to shop for the best value in healthcare. With hospitals facing increasing pressure to meet these requirements, the success of Trump’s latest push for price transparency will depend on whether stricter enforcement leads to greater compliance.