Council applauds enactment of measures to lower health care costs for employers, working families

CAA 2026 includes important hospital billing, PBM transparency, accountability provisions

WASHINGTON, DC – The American Benefits Council commends Congress and the White House for enacting long-sought bipartisan, bicameral measures to help lower health care costs.

The Consolidated Appropriations Act, 2026 (CAA 2026, H.R. 7148), signed into law on February 3, includes a package of health policy provisions, including several long endorsed by the American Benefits Council, designed to improve health care affordability:

• Honest hospital billing: Section 6225 of CAA 2026 requires every Medicare provider’s off-campus outpatient department (HOPD) to obtain a unique national provider identifier (NPI) on billing claims for services. The Council has strongly supported this provision because it will promote “fair billing” practices and help payors distinguish between sites of service to apply the appropriate payment amount.

• PBM reforms: CAA 2026 includes a set of sweeping changes governing pharmacy benefit managers (PBMs) with respect to transparency, reporting and rebate pass-throughs. The Council has consistently emphasized the vital importance of health care price transparency across the industry, including the prescription drug pricing system, and the need for greater transparency and oversight of PBMs.

In written statements to the U.S. House of Representatives Ways and Means Committee and Energy and Commerce Committee earlier this year, the Council urged lawmakers to “advance bipartisan policies that target the root causes of rising health care costs, namely a lack of transparency and competition and misaligned incentives that drive higher-cost care.” While employers continue their efforts to lower health care costs, federal legislative solutions are needed to create a more competitive, transparent health care marketplace and to remove payment distortions that drive higher-cost care.

“The measures enacted this week represent a critically important first step in addressing the root causes of high health care costs: namely a lack of transparency and competition and misaligned incentives that drive higher-cost care,” said Ilyse Schuman, senior vice president, health and paid leave policy. “In its role representing employer health plan sponsors, the Council will continue to promote policies that further advance health care affordability.”

# # #