Sponsors (6)
Official title: To ban anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care.
Introduced November 21, 2025 by Jodey Cook Arrington · Last progress November 21, 2025
The bill increases transparency and competition to help patients choose lower-cost, higher-quality care and to pressure prices down, but it imposes compliance and contractual burdens, raises privacy risks around expanded data sharing, and leaves exemptions that may preserve advantages for large integrated systems.
Patients (including Medicare, Medicaid, and people with chronic conditions) receive clearer provider-specific cost and quality information, letting them choose higher-quality and lower-cost care.
Taxpayers and small-business owners may benefit from increased competition as limits on anticompetitive facility/insurer contracting can put downward pressure on health care prices over time.
Group health plan enrollees — and the small businesses that sponsor those plans — can be steered or given incentives to use lower-cost providers, potentially lowering enrollees' out-of-pocket spending.
Insurers and group health plans — and ultimately taxpayers and small-business plan sponsors — will face compliance costs to revise contracts, implement data-sharing processes, and submit annual attestations.
Hospitals, health systems, and healthcare workers may experience administrative and contractual disruption from having to renegotiate or unwind exclusive or affiliate agreements.
Patients (including those with chronic conditions) face privacy and re-identification risks because broader sharing of de-identified claims data could be mishandled or re-identified despite HIPAA alignment.
Based on analysis of 2 sections of legislative text.
Bans insurer/facility contract terms that block plan steering or data-sharing, expands gag-clause prohibitions, and requires annual plan attestations of compliance.
Prohibits contracts that block group health plans, issuers, or employers from steering enrollees to higher-quality, lower-cost providers or from sharing provider-specific cost and quality information. The bill expands existing "gag clause" protections, adds explicit prohibitions on certain insurer/facility contract terms that limit competition, requires annual plan attestations of compliance, and preserves reasonable limits on public disclosure.