Sponsors (2)
The bill substantially increases transparency and consumer-facing standardization to help people compare and choose health plans, at the cost of added reporting and implementation burdens for insurers and exchanges that could raise premiums, strain smaller issuers, and create privacy or interpretation risks unless carefully managed.
Millions of consumers — including patients with chronic conditions, uninsured people, low-income and middle-class families, and Medicare beneficiaries — will get standardized, plain-English plan-level information (premiums, deductibles, out-of-pocket maximums, network type, cost-sharing, recent enrollment counts and MLR components) that makes comparing and choosing plans much easier.
Medicare Advantage enrollees specifically gain plan-specific MLR detail and clearer comparable information on benefits and network/cost-sharing, improving beneficiaries' ability to assess value and hold plans accountable.
Patients who rely on regular services can more easily identify standard cost-sharing for the services they use (specialist visits, imaging, labs, branded/generic drugs) and the bill clarifies HSA eligibility and preventive coverage, helping budgeting, access to care, and use of tax-advantaged savings.
Insurers and Medicare Advantage organizations will face increased compliance, reporting, and document-reformatting costs — burdens that are likely to be passed on partly to consumers through higher premiums and that may disproportionately strain smaller issuers, reducing competition in some markets.
Requiring public publication of detailed financial and enrollment data risks exposing proprietary business information, creating competition concerns, and (absent strong safeguards) a modest risk of re-identification of sensitive contract or provider-payment details.
State Exchanges and state governments will incur implementation and technical costs to add and display the new data by the 2029 deadline, potentially diverting limited resources from other state priorities or causing configuration delays.
Based on analysis of 4 sections of legislative text.
Requires issuers and MA plans to publish and submit consumer-friendly breakdowns of premium/revenue spending and directs HHS to issue standardized benefit/coverage guidance.
Official title: To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to ensure health insurer accountability through publishing of overhead costs and claim payments, and to direct the Secretary of Health and Human Services to issue guidance on the provision of certain insurance information.
Introduced June 23, 2026 by August Pfluger · Last progress June 23, 2026
Requires health insurers and Medicare Advantage organizations to publish clear, consumer-friendly breakdowns of how premium and plan revenue are spent and to submit that information to HHS (and to Exchanges where applicable). It also requires Health Insurance Exchanges to display those issuer-submitted premium-spending data for plans offered through the Exchange and directs HHS to issue standardized, plain-English guidance on how plans should present benefit and coverage information. The bill sets effective dates: public reporting of detailed premium and revenue breakdowns for plan years beginning January 1, 2027; HHS guidance on standardized benefit/coverage presentation by January 1, 2028; and Exchange display of submitted premium data for plan years beginning January 1, 2029.