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July 26, 2023

Dear Chair Smith and members of the House Ways and Means Committee:

Patients should have the right to know how much a medical procedure is going to cost them before they obtain treatment. Unfortunately, today, too many patients get pricing information only after the fact, in an explanation of benefits. 

On behalf of Independent Women’s Voice (IWV), the leading national women’s organization dedicated to advancing policies that actually enhance people’s freedom, opportunities, and well-being, we write to thank you for your willingness to engage in this important debate and offer proposed legislation that aims to deliver much-needed transparency and competition to our healthcare system.

H.R. 4822, the Health Care Price Transparency Act of 2023, has the potential to help patients if it is amended in a few critical ways. While many in the hospital industry would prefer using a price estimator tool instead of offering patients real price information, estimates aren’t prices. If patients don’t have real prices, we don’t have real price transparency. And patients should have access to all prices—including the negotiated rates their insurers pay on their behalf—in a machine-readable format. This is what is needed in order for patients, and others, like employers and price-comparison tools such as applications and websites, to make decisions that save money and lower overall healthcare costs.

Sadly, we know that unless hospitals are held to this high level of accountability, they will continue to keep as much pricing information secret as possible. These requirements—real prices, negotiated rates, and machine-readable files—are already included in federal regulations (which are currently under-enforced), but H.R. 4822 in its current form has the potential to undermine these existing regulations. We call upon lawmakers to amend H.R. 4822 to make it just as strong as federal price transparency regulations—or even stronger.

Medical price transparency is a rare area of bipartisan agreement among the American people; about 90% of Americans say they are in support. But despite this widespread support, price transparency is not yet a reality for patients because too often, the issue is dominated by special interests, who manipulate the legislative process and replace real price transparency with loopholes and half-measures that can ultimately make price transparency efforts ineffective. We hope you won’t let this happen with HR 4822. Along with this letter, we are enclosing a checklist that contrasts the language of “real” price transparency with “fake” price transparency for your use. 

We should not have to guess how much a procedure, test, or service will cost. To ensure that patients can get healthcare prices ahead of time and actually shop around for the best value, we urge you to champion policies that allow patients to see real healthcare prices upfront. Policies must also ensure greater compliance with federal price transparency regulations, such as the Hospital Price Transparency Rule

We would welcome the opportunity to discuss this critical issue as well as any of the reforms that we have put forward for your consideration. Thank you.


Hadley Heath Manning

Vice President for Policy
Independent Women’s Voice