By Andrew Rice | The Center Square
Trent England, executive director of Save Our States, says the issue is significant for taxpayers because they pay for federal employees health-care benefits. He said the system is opaque and does not provide appropriate access to the most competitive prices in the market.(The Center Square) – Taxpayer advocates are applauding the Trump administration over its efforts calling for medical price transparency in federal employee health-care plans while health-care industry leaders are pushing back.
The Office of Personnel Management requested comments from industry leaders and health-care experts on transparency within claims data for federal employee health insurance plans.
Trent England, executive director of Save Our States, said the issue is significant for taxpayers because they pay for federal employees health-care benefits. He said the system is opaque and does not provide appropriate access to the most competitive prices in the market.
“Hospitals and other medical providers set their prices, and they benefit from the opacity,” England told The Center Square. “They benefit from the fact that it’s just hard to see.”
England said that open access to claims data could mean the difference between paying $20,000 or $12,000 for the same procedure.
The Trump administration’s pursuit of claims data from insurance companies could have an impact on private health-care insurers as well, England pointed out. He said hospitals across the country are starting to provide upfront cost assessments more often.
“We have to be able to ask the questions about why some things cost so much and other things cost so little,” England said.
Andrew Bremberg, former director of the Domestic Policy Council in the first Trump administration, applauded OPM’s efforts to pursue price transparency for federal worker insurance plans.
“It’s vital that OPM get this claims data so they can detect fraud and fight back against it,” Bremberg told The Center Square.
He said the work in health-care price transparency has been ongoing since the first Trump administration. Bremberg pointed to a recent settlement from Horizon Blue Cross Blue Shield of New Jersey.
The insurance provider agreed to pay $100 million in November to resolve claims that it overcharged the plan in order to secure a contract to manage New Jersey’s public employee health plans.
“The health plan was paying out claims using taxpayers’ money, not their money,” Bremberg said. “The taxpayers’ money was paying out claims at a higher amount than what the provider had even billed.”