Obamacare Deadlock Drags On, But One Healthcare Fix Could Slash Medical Costs Nationwide

The debate over expiring Obamacare subsidies has dominated national political discourse, but some experts told the Daily Caller News Foundation that Republicans could capitalize on growing momentum around price transparency to help lower healthcare costs for Americans.

The record-setting government shutdown was driven by Democrats’ refusal to budge on the expiring Obamacare premium subsidies, which they passed in 2021 without GOP support and set to expire at the end of 2025. Republicans are still debating their healthcare proposal, including whether to back a limited extension of those subsidies.

Even without a resolution on the subsidies in sight, some experts note that more can be done to build on the healthcare-related measures already taken. That includes President Donald Trump’s February executive order directing agencies to fulfill “radical price transparency” and require the disclosure of the actual prices of healthcare services.

Proponents of the executive order say that further measures could drive down costs by increasing competition and giving Americans more control over their healthcare spending.

“When Americans can see what they’re actually paying for in health care, competition works. Costs fall, middlemen lose their grip, and Americans get control over this critical part of their lives,” former House Speaker Newt Gingrich said in a statement to the DCNF.

“With President Trump’s transparency platform already in motion, now is the perfect time for his administration and Congress to deliver real affordability through ‘radical transparency,’” he said.

Trump’s executive order builds on an earlier order he signed in 2019, which required hospitals and health plans to provide price estimates for certain services. Shortly before leaving office in 2021, the president also signed the No Surprises Act, which bans surprise medical bills, requires providers to offer good-faith estimates of expected charges, and directs insurers to send patients an advanced explanation of benefits (AEOB).

If fully implemented, price transparency regulations could yield as much as $80 billion in annual healthcare savings, according to some estimates.

“Price transparency will reveal prices that vary 10x within a hospital depending on a patient’s plan, drive competition, protect from overcharges and lower costs,” Cynthia Fisher, founder and chair of PatientRightsAdvocate.org, told the DCNF. “Real prices will transform healthcare for the benefit of all patients, employers, workers, unions, and taxpayers.”

However, enforcement of the No Surprises Act stalled during the Biden administration, and the AEOB requirements have yet to be implemented nearly five years after the law’s passage.

Fisher on Tuesday wrote to the president, urging him to direct the Centers for Medicare & Medicaid Services to issue and enforce the AEOB rule, begin delivering pricing information in 2026, and ensure employers have access to data needed to negotiate lower costs for employees, among other recommendations.

“By doing this, you will deliver a system in which patients, employees and unions — not the insurance and healthcare industry fat cats — hold the power,” Fisher wrote.

Lawmakers have also proposed codifying price transparency rules. The bipartisan Patients Deserve Price Tags Act, introduced by Republican Sen. Roger Marshall of Kansas and Democrat Sen. John Hickenlooper of Colorado, would codify Trump’s 2025 executive order and require machine-readable files of all negotiated rates and cash prices between plans and providers, and mandate that hospitals post actual prices for all services starting in 2026.

Healthcare will be a critical issue in the upcoming midterms, according to a September Echelon Insights poll.

By a nine-point margin, voters said they trust Democrats more than Republicans on healthcare. However, the poll found that if in 2026 Trump requires providers to give patients actual prices before care, 62% of respondents said they would support the president’s healthcare agenda.

Moreover, half of the respondents said they would be more likely to back a midterm candidate who “helped Donald Trump deliver actual prices before care to patients.”

At the same time, Republicans in Congress are developing proposals to redirect Obamacare subsidies away from insurers and toward consumers purchasing their own coverage. The GOP argues such a shift would give individuals more control over their plans. The concept appears to have the backing of the president, who earlier in November called on Republicans in Congress to send dollars directly to Americans.

“The insurance companies are making a fortune. Their stock is up over 1,000% over a short period of time … Why don’t we just pay this money directly to the people of our country and let them buy their own health insurance?” the president said on Nov. 16.

“For decades, politicians have failed to stand up to medical industry executives who refuse to provide upfront prices to patients. Thankfully, those days are ending,” Trent England, executive director of Save Our States, told the DCNF. “President Trump is pushing for transparency and accountability in health care. He has the power today to deliver real results for the American people.”

But with less than a month until the expiration of the subsidies, no official proposal has been endorsed by either the president or Republican leadership.

Meanwhile, Democrats have made the impending expiration of enhanced ACA subsidies, along with broader Republican healthcare reforms, a top midterm attack line. They warn that without an extension, premiums will surge for millions of Americans and thousands will die, framing any Republican opposition as an attempt to gut Obamacare.