HR-9390-119
Ordered to be Reported (Amended) by the Yeas and Nays: 24 - 21.
Sponsored by Mariannette Miller-Meeks (R-IA)
What it does
This bill would amend the Public Health Service Act to require hospitals, ambulatory surgical centers, laboratories, and imaging providers to physically post cash prices on their walls — in areas specified by the Secretary of Health and Human Services — beginning January 1, 2028. The prices posted must be the discounted cash price (or median cash price paid by self-pay patients over the prior three years if no discounted cash price exists) for each CMS-designated "shoppable service," expressed as a dollar amount. For laboratories and imaging providers where no discounted cash price exists, the gross charge would be posted instead.
Who benefits
Uninsured and self-pay patients who would gain immediate, visible access to price information at the point of care. Patients with high-deductible health plans who pay out-of-pocket for many services. Lower-income patients who may not have internet access to find prices online. Patients in rural or underserved areas with limited ability to comparison-shop digitally. Consumer advocacy organizations focused on healthcare price transparency. Competing facilities that already voluntarily post prices and would benefit from a level playing field.
Who is hurt
Hospitals, ambulatory surgical centers, laboratories, and imaging centers that would bear compliance costs — including printing, updating, and displaying price lists across potentially large facilities. Facilities with complex, frequently changing price structures may face ongoing administrative burdens. Insurers and providers who benefit from price opacity in negotiations could face indirect competitive pressure. Patients who may be confused or deterred by posted prices that differ from their actual insured cost, potentially leading to care avoidance.
Supporters argue
Supporters argue that existing federal price transparency rules — which require hospitals to post prices online — have had limited real-world impact because patients rarely search for prices before receiving care. They contend that physical wall postings bring price information directly to patients at the moment of decision, mirroring how prices are displayed in virtually every other consumer market. Studies have shown that price transparency can reduce costs for shoppable services, and that self-pay patients — who are often among the most financially vulnerable — are least likely to navigate hospital websites to find pricing information.
Opponents argue
Opponents argue that posted cash prices are largely irrelevant to the roughly 90% of Americans with health insurance, whose actual costs are determined by negotiated insurer rates and cost-sharing structures that cannot be captured in a single wall posting. They contend that displaying gross or cash prices without context may mislead patients into believing they will owe those amounts, potentially causing unnecessary care avoidance or financial anxiety. Critics also argue that the compliance burden — particularly for large facilities with hundreds of shoppable services — would impose real administrative costs that could ultimately be passed on to patients and payers.