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On February 25, 2025, President Donald Trump signed an executive order (EO) called Making America Healthy Again by Empowering Patients with Clear, Accurate, and Actionable Healthcare Pricing Information. This EO aims to enhance healthcare by providing patients with clearer pricing, fostering competition, innovation, affordability, and quality.
Health Plan Price Transparency
In response to a 2019 executive order, the Departments of Labor, Health and Human Services, and the Treasury issued a final rule in November 2020 mandating new price transparency disclosures for group health plans and insurers.
- Machine-readable files (MRFs): Starting July 1, 2022, health plans must publicly share detailed pricing in three MRFs, covering in-network rates, out-of-network charges, and prescription drug prices. However, enforcement related to prescription drug cost MRFs has been delayed.
- Self-service price comparison tools: Health plans must offer an online tool for participants to view personalized pricing and cost-sharing details for all covered items and services, including prescriptions. Starting January 1, 2023, this was required for 500 items, and by January 1, 2024, it must cover all items.
The Executive Order
The EO highlights stalled progress on federal health care price transparency since Trump's first term. To empower patients with essential information for informed decisions, it mandates the following actions within 90 days:
- Disclose actual prices of items and services, not estimates;
- Standardize and simplify pricing information; and
- Update enforcement policies for transparent, accurate data reporting.
Action Steps
Although most employers rely on their issuers or third-party administrators to satisfy many transparency requirements, employers should still monitor this topic for additional guidance from federal agencies. Download the bulletin for more details.
National Insurance Services is not a law firm and no opinion, suggestion, or recommendation of the firm or its employees shall constitute legal advice. Readers are advised to consult with their own attorney for a determination of their legal rights, responsibilities and liabilities, including the interpretation of any statute or regulation, or its application to the readers’ business activities.
