Sponsors (6)
The bill increases transparency and competition to help patients and buyers find lower-cost, higher-quality providers, but does so at the cost of new compliance and operational burdens, potential privacy risks, and uneven effects from limited exemptions.
Patients (including Medicare/Medicaid and those with chronic conditions) receive clearer, provider-specific cost and quality information, enabling more informed choices about seeking higher-quality, lower-cost care.
Enrollees and employers can be steered or incentivized toward lower-cost providers and anticompetitive contracting is limited, which can increase competition and reduce out-of-pocket and system-wide health care prices over time.
Researchers, plan sponsors, and health system managers gain access to de-identified claims and encounter data for analysis, improving transparency, oversight, and plan design decisions.
Insurers and group health plans will incur new compliance costs to revise contracts, implement data-sharing, and submit annual attestations, which could raise administrative spending and premiums.
Hospitals, health systems, and health care workers may face significant administrative and contractual disruption from needing to revise exclusive or affiliate agreements and operational workflows.
Expanded sharing of de-identified claims and encounter data, even if aligned with HIPAA, raises risk of re-identification or mishandling that could threaten patient privacy, particularly for people with chronic conditions.
Based on analysis of 2 sections of legislative text.
Prohibits contract terms that block plans/issuers from steering enrollees or sharing provider-specific cost/quality data, requires annual plan attestation, and limits certain anti-competitive clauses.
Introduced November 21, 2025 by Jodey Cook Arrington · Last progress November 21, 2025
Prohibits contract terms that stop health plans and insurers from steering enrollees to higher-quality, lower-cost providers or from sharing provider-specific cost and quality information. It expands existing bans on so-called gag clauses to cover facility and insurer agreements, requires group health plans to attest annually to compliance, and preserves narrow, reasonable limits on public disclosure. The bill also adds explicit prohibitions on contract terms that force plans to sign additional affiliate agreements, accept affiliate payment terms, or prevent other plans from paying lower rates, while carving out specified HMO exclusivity arrangements.