Sponsors (12)
The bill increases consumer price transparency and expands access to care (e.g., via pharmacist‑administered drugs, HSA flexibility, and marketplace pools) and tightens oversight of payments, but delivers those benefits at the cost of substantial new reporting, compliance, privacy and enforcement burdens on providers, plans, manufacturers, and governments that could raise prices, cause implementation challenges, and produce uneven effects across providers and states.
Most patients (insured and uninsured) will get standardized, machine‑readable, and plain‑language price and negotiated‑rate data for hospital and ASC services, improving the ability to compare costs and estimate out‑of‑pocket spending before care.
Group health plans, plan sponsors, and government purchasers will receive regular, detailed claims, pricing, rebate, and payment data that enables stronger auditing, oversight, and negotiation of plan costs.
Medicare, Medicaid, and other patients will gain faster, easier access to certain low‑risk medications at pharmacies and similar settings because pharmacists, APRNs, PAs and similar clinicians can furnish and administer designated drugs under a federal protocol.
Hospitals, ASCs, health plans, and vendors will face substantial new administrative, IT, and compliance costs to assemble, update, and publish standardized price, claims, and rebate data (including monthly updates), costs that may be passed on to patients or divert resources from care.
Publishing negotiated rates and contracting algorithms could change payer‑provider contracting behavior and prompt price coordination or shifts that raise premiums or negotiated prices for some insured patients.
Very large civil monetary penalties and per‑day fines for technical or substantive reporting failures create high legal and financial risk for providers and plans and may lead to defensive behavior, litigation, or reduced public data sharing.
Based on analysis of 7 sections of legislative text.
Rewrites HSA limits, creates ERISA marketplace pools and strong provider/price-disclosure rules, boosts hospital/ASC price transparency, changes Medicare Part B drug rebate mechanics, and authorizes federal expanded-access drugs for non-physician providers.
Official title: To amend the Internal Revenue Code of 1986 to increase the limitations on contributions to health savings accounts, to amend the Public Health Service Act to provide for hospital and insurer price transparency, and for other purposes.
Introduced April 16, 2026 by Eric Burlison · Last progress April 16, 2026
Changes how health savings account (HSA) contribution limits are set and adds a new age-based catch-up tied to other Code limits; creates new ERISA rules to let “health marketplace pools” offer group coverage; strengthens hospital and ambulatory surgical center price-transparency requirements; requires quarterly disclosures from health plan service providers about pricing, rebates, and payment flows; adjusts Medicare Part B payment/rebate mechanics for drugs subject to negotiated maximum fair price; and creates a federal list and national protocols for certain expanded-access prescription drugs that pharmacists and other non-physician providers may dispense under federal preemption (with a State opt-out).