Addressing Hidden Costs in American Healthcare

Americans sense a breakdown in the healthcare system. Premiums surge, deductibles rise, and medical bills often include inexplicable charges. At the core of these issues lies a healthcare system steeped in secrecy.

On May 18, President Donald Trump tackled drug pricing by expanding TrumpRX, a unique platform that helps Americans find lower drug costs. This platform resembles Airbnb or Priceline.com but for medication. His next target should be the hospitals and insurance companies.

Healthcare is one of the most pricey and opaque sectors in the American economy. Hidden costs, unclear billing systems, and numerous intermediaries cost taxpayers and families hundreds of billions annually due to fraud, waste, and abuse.

The Trump administration has the necessary authority to provide relief to Americans now, but enforcement is missing.

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President Donald Trump discussed TrumpRx on Feb. 5, 2026, at the Old Eisenhower Executive Office Building in Washington, accompanied by Centers for Medicare & Medicaid Services Administrator Dr. Mehmet Oz.

There are three steps that could drastically reduce costs, uncover fraud, and rebuild trust in the healthcare system:

1. Provide patients with prices before treatment, enabling them to combat fraud, waste, and abuse.

Currently, patients only discover the true cost of their care post-treatment, when bills arrive. This timing hinders cost comparison and challenging unjust charges.

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The No Surprises Act, enacted at the end of Trump’s first term, introduced an Advanced Explanation of Benefits (AEOB). This idea requires patients to receive itemized charges before scheduled care, detailing expected services, costs, and out-of-pocket expenses. Under President Joe Biden, this protection languished and remains underutilized.

Implementing AEOB could immediately increase accountability. Patients could compare costs, spot inflated charges before treatment, and maintain records for future billing disputes. Like other major purchases, healthcare must present upfront pricing.

2. Enhance the federal employee health program.

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The Federal Employees Health Benefits Program is among the largest healthcare purchasers, yet transparency remains elusive.

Existing laws empower the Office of Personnel Management to demand standardized claims and pricing data, conduct thorough audits, and verify eligibility. These are essential financial controls for a well-managed organization.

Audits detect duplicate billing, inflated charges, and improper payments. Eligibility checks prevent fraudulent or outdated enrollments from unnecessarily draining taxpayer funds.

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Improving oversight could save billions without reducing benefits or needing new laws.

3. Demand transparency across employer health plans.

Most Americans receive coverage through employers or unions, yet employers lack access to essential data needed to identify fraud and manage costs.

BIPARTISAN BILL SEEKS TO STOP PHARMACY MIDDLEMEN FROM DRIVING UP DRUG COSTS FOR FINANCIAL GAIN

House Minority Leader Hakeem Jeffries, joined by House Democrats, spoke on September 30, 2025, in Washington, DC. The Department of Labor is working toward stronger compensation disclosure requirements for Pharmacy Benefit Managers under ERISA.

Transparency requirements must extend to third-party administrators, insurers, stop-loss carriers, and any entity receiving compensation from plan assets.

Employers and fiduciaries need direct access to claims data, payment records, and fee structures without interference. Currently, many employers effectively write blank checks while intermediaries obscure costs.

Transparency shifts employers from mere payers to active participants who negotiate better value for workers and businesses.

The tools exist but aren’t being properly utilized, representing an enforcement failure. Transparency rules require enforcement.

Hospitals and insurers hold federal transparency rules, yet many continue submitting incomplete or unusable data with minimal consequence.

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Americans are tired of hidden prices, surprise bills, and unexplained costs. They seek accountability. This issue transcends ideology; it involves giving patients, employers, and taxpayers insight into spending.

The authority exists, and laws are enacted. Now, enforcement is key. Maximum price transparency enforcement empowers Americans and could make healthcare affordable again. The Trump administration has the capability to make this change.