No More Sticker Shock: New Bill Forces Hospitals, Labs, and Insurers to Post Real Prices by 2027

The “Patients Deserve Price Tags Act” is exactly what it sounds like: a massive push to rip the curtain off healthcare costs. Starting in 2026 and 2027, this legislation mandates that nearly every part of the healthcare system—from your local hospital to the clinical lab that runs your blood work and the insurer that covers it all—must publicly post detailed price tags.

This isn't just about posting the full, ridiculous sticker price (the ‘gross charge’). It’s about forcing the disclosure of the negotiated rates between providers and specific insurance companies, the cash price for self-pay patients, and the highest/lowest rates agreed upon. This means that for the first time, you could potentially look up the exact price your insurance company (say, Blue Cross PPO Plan A) has negotiated with your local hospital for an MRI before you even schedule the appointment (Sec. 2).

The End of the Sticker Price Shell Game

For hospitals, clinical labs, imaging providers, and ambulatory surgical centers (ASCs), the new compliance dates start kicking in around January 1, 2026, and July 1, 2027 (Sec. 2, 3, 4, 5). The core requirement is massive: they must post prices for hundreds of “shoppable services” in a standardized, machine-readable format. Think of it like a giant, searchable spreadsheet of every potential procedure.

This is a big deal for anyone managing a chronic condition or needing an elective procedure. If you need a specific lab test, you can compare the cash price at Lab A versus Lab B. Crucially, if you choose the discounted cash price, the provider or lab must accept that as payment in full, regardless of your insurance status. This gives consumers real leverage, especially if your deductible is high and the cash price is cheaper than your negotiated rate (Sec. 3).

Your Insurance Card Gets a Crystal Ball

Right now, when you look up a service on your insurer’s website, you usually get a vague estimate. Under this act, that changes dramatically. Health plans must launch online tools that provide real-time responses showing your exact cost-sharing amount for a service with a specific provider (Sec. 6).

This means if you’re looking at getting a colonoscopy, the tool must tell you, based on your current deductible status, that you owe exactly $450 for the procedure at Dr. Smith’s office. If the tool gives you a wrong estimate and you end up owing more, the plan must “hold you harmless” for the difference (Sec. 6). That’s a huge win for preventing surprise bills.

On top of that, starting in 2026, health plans must send you a detailed Explanation of Benefits (EOB) within 45 days of a service, breaking down every charge, code, and how much the plan paid versus what you owe. This EOB must be clear and use plain language, making it much harder for providers to sneak in confusing charges (Sec. 10).

Banning the Gag Clauses

One of the most powerful—and least visible—parts of this bill is Section 7, which tackles the opaque contracts between group health plans (like the one your employer offers) and their service providers, such as Pharmacy Benefit Managers (PBMs) or third-party administrators (TPAs).

Currently, many contracts contain “gag clauses” that prevent the plan’s fiduciary (the person legally responsible for managing the plan) from accessing critical data about claims, payments, and true costs. This bill voids any contract clause that unreasonably delays or limits access to this data. It mandates that PBMs and others must hand over detailed, quarterly reports on pricing formulas, rebates, and administrative fees to the plan fiduciary at no cost (Sec. 7, 8). If they refuse, they face civil penalties of up to $100,000 per day.

Why does this matter to you? Because when plan managers can see exactly where the money is going—how much the PBM is keeping in rebates, or what the TPA is charging for administration—they gain leverage to negotiate better deals, which should, in theory, translate to lower premiums and better benefits for employees.

The Cost of Compliance and the Enforcement Hammer

For providers and insurers, the administrative burden of compiling all this data in standardized, machine-readable formats is significant. It’s going to require major investments in IT and compliance staff. However, the penalties for non-compliance are severe and non-waivable.

Hospitals face escalating daily fines that can quickly reach hundreds of thousands of dollars for persistent violations (Sec. 2). Health plans can be fined up to $300 per member, per day, up to $10 million (Sec. 6). This level of financial threat suggests the government is serious about enforcement. For the patient, this means the risk of getting a surprise bill from an itemized charge is significantly reduced, as providers can’t start collections unless they meet the detailed billing requirements (Sec. 11).