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Q: What is the PRICE Transparency Act?

A: When a loved one goes to the hospital for cancer treatments, orthopedic surgery or complications from COVID-19, American consumers and taxpayers deserve to know what hospitals will charge for their services. For years I’ve heard from Iowans who are fed up with the secrecy shrouding the prices they pay for pharmaceuticals, medical care and hospital stays. Since retaking the reins of the Senate Finance Committee last year, I’ve led an 18-month, bipartisan effort to fix what’s broken in our health care pricing regime to empower consumers and taxpayers so they get the most bang for their buck. Transparency brings accountability. Whether it’s an education dollar, food dollar, defense dollar or a health care dollar, sunshine helps scrub pricing shenanigans and fuel competition. That’s the genius of the free marketplace. Robust competition in the health care sector will improve quality care, lower costs and create savings for job creation, wage growth and consumer spending. At my county meetings across Iowa, I constantly hear from Iowans about sky-high medical bills and soaring prescription drug costs. The pandemic adds even more urgency for Congress to take action now. That’s why I’ve co-sponsored the PRICE Transparency Act with Sens. Mike Braun, Joni Ernst and other leaders in the U.S. Senate. It would enact into federal law price transparency rules being implemented by the Trump administration. The federal regulations, including the one making public hospital prices, are slated to take effect in January 2021. Not surprisingly, they are being fought tooth and nail by the hospital and insurance lobbies. Without changes in federal law, they will keep fighting these regulations. When prices are left unchecked by free market forces, consumers, taxpayers and employers are left footing the tab for surprise medical bills and sticker shock at the pharmacy counter.

Q: How would your bills help lower health care prices?

A: American households and the entire U.S. economy would benefit from payment reforms I’m fighting to get passed and signed into law. The Prescription Drug Pricing Reduction Act and PRICE Transparency Act would help lower health care costs and improve health outcomes for Americans with reasonable, pro-patient, pro-taxpayer reforms. Perverse payment incentives today drive the delivery of health care services and the prescribing habits of health care providers. The COVID pandemic has delivered a stark reality check that elected policymakers can’t afford to ignore. Now is the time for Congress to address exorbitant costs of prescription drugs and pull back the curtain on insurance coverage and provider charges so patients aren’t blindsided by medical bills. From witness testimony at my Finance Committee hearings and regular constituent feedback, it’s well established that too many Americans choose between paying for food and taking their prescription medicine. Others are forced into dire financial hardship with huge medical bills they couldn’t anticipate after a visit to the hospital. Patients deserve to know the true cost of the drug, service and treatment they are receiving. The PRICE Transparency Act would require hospitals to provide patients with clear information about the prices they charge for specific services; make public all hospital standard charges on the internet; and, publish negotiated rates and charges, including cash prices in a user-friendly format. What’s more, it would require insurers to give consumers real-time access to cost-sharing information, including an estimate of their cost-sharing liability for covered health care services; publish explanation of benefits online to empower consumers to compare costs and coverage before treatment; and disclose on the internet negotiated rates for in-network providers and allowed payments for out-of-network providers. It’s obvious the current pricing system is broken and urgently needs repairs to empower patients and consumers. One of the silver linings from the pandemic might prove to be that COVID served as a catalyst to get much-needed pricing reforms across the finish line. It’s obvious Big Pharma wants to use the pandemic to keep pulling the wool over the public’s eyes and it is just as disgraceful that some lawmakers are choosing to put political calculations ahead of people’s health and pocketbooks. I’ll continue leading the charge to enact price transparency, including my efforts to require drug companies to list prices of their medicine in direct to consumer advertising. Partisan dilly dallying drags down the economy, allows inflated insurance premiums to hamper job creation and wage growth and puts people’s lives and livelihoods at risk with unaffordable prescription drug prices. What’s more, murky medical bills that have been negotiated between providers and insurers don’t allow patients to find the best price for the care they need.  

Charles Grassley

Author: Charles Grassley

Chuck Grassley of New Hartford has represented Iowa in the United States Senate since 1980.