Lawmakers aim to tackle healthcare costs, transparency with series of new bills

Wisconsin’s hospital costs are among some of the highest in the nation, and lawmakers have introduced legislation in efforts to reduce those costs for state residents.

The Senate Committee on Licensing, Regulatory Reform, State and Federal Affairs held a public hearing recently on several bills that would address the high cost of healthcare in Wisconsin.

Senate President Mary Felzkowski (R-Tomahawk) testified on a number of bills that she authored, including the Price Transparency for Patients Act, and bills to require insurer participation in Wisconsin’s all-payer claims database, the Wisconsin Health Information Organization (WHIO).

“High healthcare costs burden families and are a silent tax on businesses. Wisconsin cannot wait on Washington to act,” she said. “The bills heard in committee are common sense: what else, besides healthcare, do you buy without knowing what it costs? Strengthening Wisconsin’s healthcare data infrastructure and increasing transparency are easy steps towards tackling our state’s high cost of healthcare.”

According to Felzkowski, the Price Transparency for Patients Act adopts federal hospital price transparency standards into state law and gives Wisconsin’s Department of Health Services the ability to monitor hospitals’ compliance and enforce these standards. If a hospital is out of compliance, they can work on a corrective action plan with DHS before they incur any financial penalties.

Under the bill, a hospital is unable to pursue debt collection until they come back into compliance. According to the nonpartisan patientrightsadvocate.org, only 30% of Wisconsin hospitals are currently fully in compliance.

Senate Bills 796 and 797 require insurer participation in the WHIO and provide funding to support associated costs. WHIO allows users to see exactly what they and other payers are paying for various healthcare services, increasing transparency and lowering costs.

“Healthcare costs, especially in Wisconsin, are expensive and only increasing,” Felzkowski said. “Wisconsin has the fifth highest hospital costs in the country and the highest in the Midwest. From 2000 to 2024, medical care prices have outpaced inflation, growing 121.3%.
“In the recent state budget, the GPR Medicaid cost-to-continue was over $1.4 billion, and recent estimates are that this will be over $200 million more than what was passed in the budget.”

Cost transparency

Meanwhile, Sen. Tammy Baldwin has joined the bipartisan Patients Deserve Price Tags Act, a bill to make health care costs more transparent. The bill requires providers to publish the costs of services so Americans understand what a specific visit or procedure will cost, allowing families the opportunity to compare prices, driving competition, and lowering costs.
“Wisconsinites are struggling to afford their health care and we need to do everything we can to lower costs. Our health care system too often puts profits before patients, and we need to pull the curtain back and let families see the true cost of the care they are getting,”Baldwin said. “I’m proud to work with Republicans and Democrats to bring basic transparency so we can foster competition and lower prices for Wisconsin families.”

When Americans go to the hospital, they often don’t know what services will cost beforehand. This forces patients to rely on their insurance to pay as much as possible and negotiate rates with providers, robbing patients of the ability to shop around for a better deal. Agreements between insurers and providers also lack transparency.

The Patients Deserve Price Tags Act would create true transparency for health care pricing by requiring all negotiated rates and cash prices between plans and providers to be accessible.

Specifically, the bill would require machine-readable files of all negotiated rates and cash prices between plans and providers, not estimates, as well as require hospitals to post actual prices for 300 shoppable services (and for all services starting in 2026).

They would also have to create a requirement for each patient to receive an Explanation of Benefits statement and require providers or facilities to include a detailed itemized bill of each distinct item or service, or an all-in total price for bundled items if offered to the patient as an option.

This legislation is led by senators Roger Marshall (R-KS) and John Hickenlooper (D-CO).