5:24 am - December 5, 2025
Patients in the United States are still struggling to find clear information about the cost of surgeries and medical procedures, even after a new executive order by President Donald Trump in February 2025. The order aimed to force hospitals and insurance companies to publish clear pricing data. However, despite promises and new rules, much of the available information remains confusing and unhelpful for everyday consumers. Experts say the health care system still has a long way to go before patients can easily compare prices and make informed decisions.
Background on Price Transparency Efforts
In 2019, President Trump issued his first order on health care price transparency. At the time, it was praised as a bold move. Gary Claxton, a senior vice president at KFF Health News, said they went at the providers and the plans and made confidential data public.
However, the results have been disappointing. Hospitals and insurance companies posted complex and confusing data online. Many consumers and even experts found it hard to understand. Some lawmakers tried to pass stronger laws, but their efforts failed. Meanwhile, President Biden’s administration was criticized for not enforcing the transparency rules strongly enough.
Trump’s 2025 Executive Order
Trump’s new order criticizes past enforcement efforts. It says hospitals and insurers were not adequately held to account for incomplete or missing data. A report by the Government Accountability Office in October 2024 also found that the Centers for Medicare & Medicaid Services (CMS) did not properly check the data for accuracy.
CMS spokesperson Catherine Howden said that the agency now plans to systematically monitor compliance and help hospitals understand the requirements. However, it remains unclear if any staff changes have been made as part of the Trump administration’s broader effort to reduce the federal workforce.
Problems with Price Data
Independent researchers continue to find problems with the quality of price data. A recent report from the Peterson-KFF Health System Tracker showed that some insurers in New York City reported payments to providers who cannot perform the procedures listed. These false prices are known as ghost or zombie rates.
For example, UnitedHealthcare listed payments for heart attack treatments to dentists and optometrists. In other cases, the same insurer reported different prices for the same treatment at the same hospital. At New York-Presbyterian/Weill Cornell Medical Center, the cost of treating a heart attack was reported as $47,000, $64,000, and $70,000.
Aetna also reported paying the same price of $6,292 for a wide range of very different treatments at Mount Sinai Beth Israel Hospital.
When questioned, UnitedHealthcare said it meets price transparency rules and suggested using its cost-estimator tools. Aetna referred questions to AHIP, the insurance industry group. Chris Bond from AHIP said insurers strongly support price transparency and will work with the Trump administration to improve it.
Challenges for Consumers
David Cutler, a professor at Harvard University, explained that even when prices are available, they often do not show how much a patient will actually pay after insurance adjustments like deductibles and copayments.
Most of the price transparency information does not have that, Cutler said.
Moreover, price data does not include information about the quality of care. Cutler compared it to choosing wine at a restaurant. People assume that the more expensive wine is better, he said.
Cutler is also skeptical that transparency alone will lower costs. Instead, hospitals might use the information to ask for higher payments if they find they are being paid less than competitors.
Mixed Results So Far
The Trump administration points to some positive changes. Data shows that prices for the top quarter of the most expensive services have fallen by 6.3% per year since 2019. However, prices for the bottom quarter of services have risen by about 3.4% per year, according to research by Turquoise Health.
Patient Success Stories
Despite the challenges, some patients have used available data to their advantage. Theresa Schmotzer, a 50-year-old from Goodyear, Arizona, managed to save nearly $3,000 on outpatient surgery to remove a fibroid.
Initially, her hospital told her the procedure would cost $3,700, and asked for upfront payment. After finding price data on PatientRightsAdvocate.org, she learned the actual price should be closer to $700. Armed with this information, she negotiated her costs, ultimately paying only her $300 deductible and a $400 balance later.
When people go for surgery and are not clear upfront what the cost will be, it stokes fear, Schmotzer said.
Next Steps for Transparency
Hospitals say they want to comply with the rules. Ariel Levin from the American Hospital Association said consumers should be given complete estimates that include the total episode of care and out-of-pocket costs.
CMS has fined over a dozen hospitals for not following transparency rules. However, experts like Gary Claxton say the current flexibility in reporting makes it hard to compare prices accurately.
It does not seem to be that yet, Claxton said.
Katie Martin, CEO of the Health Care Cost Institute, agreed that transparency is just a critical first step toward understanding and improving health care costs. She said it is not the whole thing.