Markup of Fifteen Bills
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House Energy and Commerce Subcommittee on Health U.S. House of Representatives
Follow its sittingsMariannette Miller-Meeks
And if they're using denial of claims to deny care.
If you're wondering why you haven't gotten your bill from your doctor's office, often it's because it's gone to the insurance company, they've denied the claim, then your provider has to go through this arduous process of trying to prove that the claim was valid before it's finally paid off and you finally get a bill for your minimal copay. I urge all of my colleagues to support this bill. Let's get it across the finish line. Could not agree with the chair or ranking member DeGette more, sunshine is the best medicine. Thank you, I yield back.
H. Griffith
Gentleman yields back. Anyone else wish to be recognized to discuss the bill? Seeing none, the question now occurs on forwarding H.R. 9396 to the full committee. All those in favor say aye. Those opposed no.
The ayes have it and the bill is forwarded to the full committee.
Speaker 6
H.R. 9390, to amend Title 27 of the Public Health Service Act to require certain facilities to post prices on the walls. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled.
H. Griffith
Without objection, the first reading of the bill is dispensed with and the bill be open for amendment at any point. Seeing no objection, so ordered. And I now recognize the gentlelady from Iowa, Mrs. Miller-Meeks, to explain the bill.
Mariannette Miller-Meeks
Thank you very much, Mr. Chair.
I move to strike the last word on my bill, H.R. 9390, the Prices on the Wall Act of 2026. As a physician, I've spent my career helping patients navigate a healthcare system that is too often confusing, frustrating, and far too expensive. One of the biggest challenges patients face is not knowing what something will cost until weeks or even months after receiving care. Imagine walking into a grocery store, a hardware store, or a restaurant and finding that none of the prices are listed. You would never know what you are expected to pay until after you left.
Yet that's exactly how the healthcare system often works. That's why I'm proud to introduce the Prices on the Wall Act of 2026.
My legislation takes a simple common sense step towards greater transparency. Beginning in 2028, hospitals, ambulatory surgery centers, laboratories, and imaging providers would be required to post the prices of commonly shoppable healthcare services in visible locations where patients can easily see them before receiving care. The bill requires facilities to display their discounted cash prices or, when those are unavailable, often readily understandable price information directly on their walls for patients to review. For years, policymakers on both sides of the aisle have supported efforts to increase healthcare transparency. My bill builds on those efforts by making price information more visible and accessible to the people who need it most.
Healthcare consumers deserve the same transparency that exists in virtually every other sector of our economy. Price transparency empowers patients.
It encourages competition. It rewards providers who deliver the highest quality care at the most affordable cost. And it helps families make informed decisions about where they seek care. This is not about increasing bureaucracy. It is about providing patients with clear information.
It is about respecting consumers and bringing greater accountability to our healthcare system. Americans work hard for every dollar they earn, and they deserve to know what price they are paying before they receive a service. Transparency is not a partisan issue. It is a patient issue. And I have put that into effect in my practice, so it is doable.
I urge my colleagues to support the Prices on the Wall Act, and I yield back.
Thank you, Mr. Chair.
H. Griffith
Gentlelady yields back. Anyone else wishing to discuss the bill? Recognize the gentleman from New Jersey, Mr. Pallone, ranking member of the full committee, for five minutes.
Frank Pallone
Thanks, Mr. Chairman. I'm opposed to the bill, and while I support efforts to bring transparency to our nation's health system, this bill does not strengthen transparency or address the healthcare affordability crisis created by President Trump and congressional Republicans, in my opinion.
On the contrary, I'm concerned that the bill will cause more confusion for consumers and deter them from seeking care. And don't get me wrong, the intent of this bill is a good one, to bring more transparency. But I am concerned that this is just going to create more confusion because the prices that will be posted on the wall are not actually the prices that most patients would actually pay for those services. The bill says that all hospitals, ambulatory surgical centers, labs, and imaging centers have to post cash prices for healthcare services that can be scheduled in advance.
And this includes hundreds and possibly thousands of procedure codes that providers would be required to post on the wall, right? Now, hospitals are already required to publish their price information online, including for shoppable services, but requiring hospitals to post cash prices on their walls for various procedure codes would likely only confuse patients and deter insured individuals from seeking care. So patients who need care will also have to determine which procedure and billing codes that are ancillary will be furnished as part of the service. So I just think that the bill creates, you know, a sort of a false sense of transparency that will make it even more difficult for consumers who are already struggling to navigate and understand the cost of a healthcare procedure. I don't see how it helps, but I know you're well-intentioned, but I I would urge a no vote on the bill.
H. Griffith
The gentleman yields back.
Further discussion on the bill? Seeing none, the question now occurs on forwarding H.R. 9390 to the full committee. All those in favor say aye. All those opposed, no. The ayes have it, and the bill's agreed to and forwarded to the full committee.
Now call up H.R. 3514 and ask the clerk to report.
Speaker 6
H.R. 3514, to amend Title 18 of the Social Security Act to establish requirements with respect to the use of prior authorization under Medicare Advantage plans.
H. Griffith
Without objection, the first reading of the bill is dispensed with and the bill will be open for amendment at any point. Seeing no objection, so ordered. Does anyone seek to be recognized on the bill? Gentleman from Pennsylvania, Dr. Joyce, is recognized to speak to the bill.
John Joyce
Thank you, Mr. Chairman. I wish to add my own support to H.R. 3514, the Improving Seniors' Timely Access to Care Act, and urge the swift passage of this crucial bipartisan legislation by our committee.
I would also like to directly thank you and Chairwoman Guthrie, Ranking Members Pallone and DeGette for bringing this bill to us today. This bill represents truly a bipartisan product that is currently supported by over 290 House cosponsors and has the endorsement of hundreds of patient, physician, and health plan advocacy organizations. The Seniors Act will make critical improvements to the prior authorization process in the Medicare Advantage program, reducing administrative barriers that will ultimately deliver faster and more complete care to patients.
Specifically, this bill requires MA plans to adopt standardized electronic prior authorization systems to expedite the processing of requests. This will improve transparency around the utilization of prior auth in MA, it clarifies HHS authority to set timeliness for determination, and finally, mandates long overdue oversight into the prior authorization process. This represents a consensus, common sense fix to one of the glaring issues facing providers and patients today. I urge all of my colleagues to support this legislation and I yield back.
H. Griffith
Chairman yields back, now recognize the gentlelady from Washington, Dr. Schrier, for five minutes to discuss the bill.
Kim Schrier
Thank you, Mr. Chairman. I am so happy that this committee is moving the long overdue bipartisan legislation, the Improving Seniors' Timely Access to Care Act. This is a big deal. I hear from my constituents all the time that the health insurance that they have is not holding up its end of the bargain. Insurance companies are delaying or denying care due to really abusive requirements for prior authorizations where there should not be that requirement.
By the way, I hear the same frustration from doctors and from hospitals.
They're forced to hire more staff just to process prior authorization requests than nurses. The most egregious offender in all of this is Medicare Advantage, which is a type of Medicare plan that contracts with private insurance companies to deliver care. And more than half of seniors are enrolled in Medicare Advantage plans because they're often more affordable and they seem great until a patient gets sick and can't get the treatment that their doctor recommends because of abuse of a prior authorization requirement. In 2021, traditional Medicare beneficiaries saw around 625,000 prior authorization requests. Now here's a contrast.
In that same year, Medicare Advantage beneficiaries saw over 35 million prior authorization requests.
And I want you to keep in mind that enrollment in these programs is about 50-50, so this is really disproportionate. This bill is an important step toward doing the right thing for seniors by requiring Medicare Advantage plans to adopt an electronic prior authorization system and to improve transparency around Medicare Advantage prior authorization use and potential abuse. I urge my colleagues to vote for this bill, and once we pass it into law, I look forward to working with the committee to pass even more prior authorization reforms that put the doctor and the patient, and not the insurance company, back in charge of clinical decision-making. Thank you. I yield back.
Mariannette Miller-Meeks
Gentlelady yields back. Anyone else wish to discuss the measure? Recognize the gentlelady from Iowa, Dr. Miller-Meeks, for her five minutes to discuss the bill.
Thank you, Mr. Chair. I move to strike the last word. I rise in support of H.R. 3514, the Improving Seniors' Timely Access to Care Act of 2025.
As a proud original cosponsor of this bipartisan legislation and as a physician, I've seen firsthand the frustration patients experience when administrative delays stand between them and the care they need. While prior authorization can be an important tool to ensure appropriate care and manage cost, the current process is too often outdated, burdensome, and unnecessarily time-consuming for both patients and especially providers. This bill takes a common-sense approach to modernizing prior authorization within seniors' health insurance Advantage plans. It streamlines the process through electronic prior authorization, improves transparency, establishes clear timelines for decisions, and increases accountability so patients and providers have greater certainty when seeking medically necessary care. Let me give you an example of medically necessary care.
I saw a patient with very symptoms that were very subtle, no signs, and I suspected that the patient had a base of the brain brain tumor. A CT scan will not diagnose a base of the brain brain tumor because the bone gets in the way. Through prior authorization, multiple hours by my staff, multiple hours on the phone by myself, they would not approve an MRI, which was what we requested. They finally approved months later a CT scan. Then it's scheduled and it takes a couple of weeks.
Then you get the results and guess what, the CT scan didn't show anything. So the next test you have to order is now an MRI. We finally got the authorization for the MRI. We finally got the MRI and guess what the MRI showed.
Lo and behold, even though the patient had no signs and very few symptoms, the MRI showed a base of the brain brain tumor. Now, six months of delay for this patient could have been life-threatening. This is an important issue that should have, as Dr. Schrier and Dr. Joyce said, already been addressed. So for seniors, this means fewer delays and faster access to treatment, and sometimes life-saving treatment. For physicians and other providers, this means less time spent on paperwork and more time spent on actually caring for patients, which is what we prefer to do.
And for rural providers, including many in my district in Iowa, it means reducing administrative burdens that can be especially challenging for smaller practices with limited staff and resources.
Importantly, this bill does not eliminate prior authorization. Rather, it improves the process so it works more effectively for patients, for providers, and health plans alike. This legislation has earned broad bipartisan support because it addresses a problem everyone recognizes while preserving the benefits of appropriate utilization management. I thank the chairman, ranking member, and my colleagues for their work on this legislation.
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