America’s health care system is built upon a lack of transparency.1 In most states, it is nearly impossible for individuals and families to compare the cost of health care services and procedures like they would when shopping for gas, groceries, or housing. This intentional lack of transparency confuses consumers, hides true costs, and drives up prices.2
Building on successes at the state level, the Trump administration issued a new rule in 2019 focused on transparency for hospital services, designed to introduce accountability into America’s health care system.3 The rule has two basic requirements for hospitals: (1) to provide an easy-to-access file with both the charges and costs of all items and services, including gross charges, discounted cash prices, and charges negotiated with insurance companies, and (2) to display shoppable services in a consumer-friendly format.4-5 The American Hospital Association challenged the new rule in federal court, losing both its initial challenge and then again on appeal.6-7 The final rule took effect on January 1, 2021, in the final days of the Trump presidency.