For years, Americans have been told that healthcare costs are simply too complicated to understand. Hospitals charge different prices, insurers negotiate deals behind closed doors, and employers pour billions into health plans without always having the information needed to determine where the money goes.
President Donald Trump wants to change that — and his administration is pushing the healthcare industry toward greater transparency.
On October 5, the administration tightened federal healthcare price-disclosure requirements. Two days later, the Health Transformation Alliance (HTA) and the State Financial Officers Foundation (SFOF) introduced a new tool designed to help employers determine whether they are actually using that information to protect their workers and control healthcare spending.
The initiative targets a problem that has frustrated businesses and patients for years: When prices are hidden, comparing costs becomes difficult, accountability weakens, and middlemen can benefit from a system few people fully understand.
Trump's message is straightforward. Americans should be able to see what healthcare costs before the bill arrives — and the people managing their healthcare dollars should be able to explain where every dollar goes.
The stakes are enormous. HTA member companies spend more than $40 billion annually on healthcare, according to the organization, and their plans cover more than 5 million Americans. These employers have substantial purchasing power. What they need is the information to use it effectively.
Enter the Corporate Health Plan Fiduciary Scorecard, launched October 7.
The assessment contains 30 questions covering everything from access to a company's own health-plan data to vendor payments, independent audits, and the scrutiny of large medical claims. Its purpose is to help employers determine whether their healthcare arrangements are being managed with the transparency and oversight their employees deserve.
Consider the basic question at the heart of the initiative: Can a company spending millions on employee healthcare actually access the information needed to evaluate its own plan?
That should be the bare minimum, not a revolutionary idea.
Trump began pursuing healthcare price transparency during his first term, establishing requirements intended to make hospital and insurance pricing more accessible. In February 2025, he returned to the issue with an executive order directing federal agencies to enforce existing disclosure requirements and push for clear, actionable information showing actual healthcare prices rather than estimates.
Prescription drugs were a particular focus. The administration argued that inadequate enforcement under President Joe Biden had left important pricing information inaccessible or difficult for consumers and employers to use.
The broader principle fits Trump's America First approach: Give Americans the information they need to make decisions, challenge entrenched interests, and stop treating ordinary people as if they should simply accept whatever price the system hands them.
But publishing data is only half the battle.
Health and Human Services Secretary Robert F. Kennedy Jr. has criticized the way healthcare companies have presented pricing disclosures, arguing that overwhelming consumers with mountains of information can defeat the purpose of transparency. A price file that nobody can reasonably navigate does little to help a family compare plans or an employer negotiate a better deal.
And that is where the money trail becomes particularly important.
The new scorecard examines whether employers use independent advisers who receive no payments from insurers or pharmacy benefit managers. The concern is straightforward: An employer seeking objective guidance should know whether the person recommending a particular plan has financial incentives that could influence that advice.
The assessment also examines itemized reviews of claims exceeding $50,000, independent audits, and limits on shared-savings fees — payments vendors may receive for reducing healthcare costs.
Those fees deserve scrutiny. If a vendor claims to have saved an employer money, the employer should be able to verify the savings, examine the charges, and determine whether the arrangement genuinely benefits the people paying for coverage.
