President Donald Trump’s renewed push for greater health care price transparency is running into the same obstacles that plagued his first attempt, with limited compliance from hospitals and questions about whether patients will actually employ the data even if it’s available.
The effort, recently revived through an executive order and proposed regulations, comes as Republicans advocate for shifting more health care costs onto consumers through high-deductible plans and health savings accounts (HSAs). The core idea – allowing patients to shop for the best prices on medical procedures – has long been a GOP talking point, but implementation has proven difficult.
Trump’s initial attempt to mandate price transparency, signed into law in 2019 and taking effect in 2021, required hospitals to publish their standard charges online. Although, a study of the policy’s first ten months found that only about a third of facilities had complied with the regulations. The Centers for Medicare & Medicaid Services (CMS) subsequently notified 27 hospitals between June 2022 and May 2025 for non-compliance, levying fines.
The Biden administration followed up with further action, seeking to standardize data and strengthen enforcement. Trump, in early 2025, signed an executive order aiming to increase penalties for hospitals and doctors who fail to disclose their prices. CMS then proposed regulations to increase fines and require more detailed pricing information.
Despite these efforts, there’s little evidence that patients are utilizing the available data. “There’s no evidence that patients use this information,” said Zack Cooper, a health economist at Yale University. A 2021 study co-authored by Cooper found that patients needing an MRI often passed by six lower-priced providers on their way to a scheduled appointment, typically following their doctor’s recommendation.
Industry experts also express skepticism about the potential for significant price changes. Research suggests that transparency policies can have mixed effects, with one 2024 study of a Novel York initiative finding a marginal increase in billed charges.
The difficulties stem from several factors. Patients often don’t compare prices, and medical services are complex to evaluate. A simple delivery, for example, can result in vastly different charges depending on whether medications are administered to induce labor or if an emergency cesarean section is required.
the data is often presented in a format that is difficult for patients to understand, buried in spreadsheets and requiring specialized knowledge of billing codes. The American Hospital Association told the Trump administration in July 2025 that hospitals craft “detailed assumptions about how to apply complex contracting terms and assess historic data to create a reasonable value for an expected allowed amount” when calculating these costs.
The varying contracts hospitals have with insurers also contribute to price discrepancies. Jamie Cleverley, president of Cleverley and Associates, explained that the cost for a patient with one health plan can differ significantly from the cost for another patient with a different plan.
Instead of empowering patients, the mandated data has become a key tool for negotiations between health care providers and insurers. Marcus Dorstel, an executive at price transparency startup Turquoise Health, stated that the primary use of the pricing data is “to use that in their contract negotiations.” Turquoise Health, along with other startups, assembles and analyzes price data, often advertising their services to hospitals and insurers.
Eric Hoag, an executive at Blue Cross Blue Shield of Minnesota, confirmed that his insurer uses the transparency data to ensure competitive rates with other health plans. He also noted that providers often leverage the data during negotiations, arguing for higher payments based on rates offered to other insurers.
As of mid-February 2026, the effectiveness of the price transparency policies remains uncertain, and the debate over how to lower health care costs continues.
