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Health CareSecurityCommentary

Transparency in Coverage Can Help American Mothers Now, Not Later

tiaramaio via Getty Images

Alleigh Marré is the executive director of the American Parents Coalition and a mother of four.

American families have long made the commonsense argument that we must know the price of health care before we receive it.

Nowhere is the lack of price transparency more evident than in childbirth, and the months leading up to it, where millions of women and families make life-altering medical decisions without any clear understanding of what those decisions will cost them. 

Today, expecting mothers routinely enter hospitals blind. They may know their due date, their doctor, and their birth plan, but not whether delivering their child will cost $5,000 or $50,000. Even women with insurance often learn the true price only weeks or months after giving birth, when the bills arrive and financial stress replaces what should be a moment of joy.  

President Donald Trump has consistently argued that Americans deserve to better understand health care costs and the Transparency in Coverage Rule was meant to fix this.

The rule requires insurers to disclose negotiated rates so families can compare prices and plan. But in practice, the system still isn’t working. Price files that are posted are often massive, inconsistent, difficult to locate, and nearly impossible for ordinary consumers to use.  

The Centers for Medicare and Medicaid Services has taken an important step by proposing updates to the Transparency in Coverage rule. The agency has acknowledged what parents already know, that the current approach fails real people. Increasing enforcement, standardizing files, eliminating junk data, and improving usability are meaningful improvements. But these fixes will not help mothers if they arrive too late. 

Under the proposed rule, insurers would not be fully accountable until 2028. That delay is unacceptable for families today, especially as insurers have been expected to publish data since 2022. They should not be building new systems from scratch, but rather refining existing ones. There is no justification for forcing American families to wait another two years for information they need now. 

Accelerating implementation would send a clear message: transparency is not optional, and it is not theoretical. It is a real tool for families trying to budget, save, and avoid medical debt–especially at childbirth, a vulnerable moment for both mom and baby. 

Accountability must also be strengthened. While compliance still needs much improvement, hospitals are already required to attest to the accuracy of their price transparency files. Insurers should be held to the same standard. Without an executive attestation, no one is responsible for whether the data is accurate, complete, or meaningful. Transparency without accountability is merely paperwork. 

Most importantly, price information must reflect reality.

Mothers don’t need abstract numbers. They need prices that actually determine what they will pay. That means including payment mechanics like bundled maternity fees, lactation consultants, in-hospital pediatric visits, NICU services, exclusions, and network definitions.

Without this context, so-called “prices” cannot help families make informed decisions. 

Trump has made clear his commitment to health care price transparency.  His administration has made transparency a pillar of their Great Healthcare Plan and they’ve often spoken about restoring fairness, lowering health care costs, and standing up for families. Delivering faster, stronger Transparency in Coverage advances all three goals.

When mothers can compare prices before giving birth, stress diminishes, costs come down, and families regain control. 

American parents are not asking for special treatment. They are asking for clarity. They are asking to know the cost of welcoming a child into the world before the bill arrives. 

The Trump administration can deliver transparency that works for real people. By telling the Centers for Medicare and Medicaid Services to accelerate implementation and strengthen accountability, Trump and Health and Human Services Secretary Robert F. Kennedy can help give mothers the honest prices, real choices, and peace of mind they deserve, when it matters most.

We publish a variety of perspectives. Nothing written here is to be construed as representing the views of The Daily Signal.

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