Mark Galvin: Price transparency critical for ACA success

By Mark Galvin, Manchester Union Leader

NEW HAMPSHIRE has always been a national leader helping citizens navigate the complexity of health insurance.

In 1851, New Hampshire was the first state in the nation to establish an insurance regulatory agency.

In 2003, New Hampshire emerged as the nation’s leader on healthcare transparency, becoming the first state to establish an All-Payer Claims Database (APCD). The APCD enhances price transparency and provides healthcare stakeholders with vital information about the factors contributing to rising healthcare costs.

It was healthcare policy experts at the University of New Hampshire that launched, and is the home of, the nation’s APCD Council, which has been instrumental in standardizing and driving healthcare price transparency for all Americans.

Today, we are on the verge of seeing New Hampshire’s efforts lead to complete healthcare market transparency for all American families — something that has been elusive but more recently has become critical to the survival of small businesses and the middle class. We, and the 88% of Americans who support this initiative according to the Harvard Harris poll published in May, need your help to get this “over the goal line”.

As residents of New Hampshire impassioned to contain and drive down healthcare costs, we call on Senators Maggie Hassan and Jeanne Shaheen to continue our state’s leadership as innovators and pioneers within the insurance industry.

Introduced to the Senate on June 30th, 2020, and sponsored by Sen. Mike Braun of Indiana, Senate Bill 4106 — to amend the Public Health Service Act to provide for hospital and insurer price transparency — can unify the nation on this significant bipartisan issue.

Referred to as the “Health Care PRICE Transparency Act”, it aims to provide consumers of healthcare with transparent pricing information on the specific negotiated payment rates between the plan and health care providers for all items and services covered under the plan. Hassan and Shaheen could be the first Democratic senators to co-sponsor this bill.

The bill would enhance the Affordable Care Act and increase healthcare quality and access for all Americans. Following the initial iteration of price transparency provided through the ACA, which required hospitals to make their prices transparent by publishing their “chargemasters”, this new act can provide more meaningful, relevant pricing information to help patients receive more value from their healthcare dollars.

Price transparency is an essential component of a competitive, well-functioning free market. It empowers consumers to shop for the most effective, low-cost health care available. This, in turn, creates a path to contain and control healthcare costs for Americans and alleviates the financial burden of the unpredictable, and oft-unreasonable, out-of-pocket medical costs.

The financial relief experienced by many as a result of this bill would put real dollars back into the pockets of Americans and businesses, providing a much-needed boost to our economy.

Again, let us maintain our state’s status as a leader within the insurance industry. Hassan and Shaheen would help New Hampshire and the nation if they were to co-sponsor The Health Care PRICE Transparency Act (S. 4106), and, further, to see that the act gets passed.

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Ensuring Compliance with the No Surprises Act and Transparency in Coverage Rule