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Premium Transparency Act

USA119th CongressHR-9397| House 
| Updated: 6/25/2026
August Pfluger

August Pfluger

Republican Representative

Texas

Cosponsors (3)
Robert J. Wittman (Republican)Nathaniel Moran (Republican)Craig A. Goldman (Republican)

Ways and Means Committee, Health Subcommittee, Energy and Commerce Committee

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted
The Premium Transparency Act seeks to increase accountability and transparency within the health insurance industry by requiring detailed public disclosure of financial information from health insurers and Medicare Advantage plans. Starting January 1, 2027, health insurance issuers offering group or individual coverage must submit and publish on their websites the percentage of total premium revenue spent on claims, quality improvement, and administrative costs, along with the percentage of revenue they retain. Similarly, Medicare Advantage organizations will be required to disclose their total revenue, the amounts and percentages spent on incurred claims and non-claims costs, and the difference between their Medical Loss Ratio (MLR) numerator and denominator. This bill also mandates that health insurance Exchanges incorporate this newly required financial data into their comparative information for qualified health plans, starting with plan years beginning on or after January 1, 2029. This aims to provide consumers with more comprehensive data when selecting health plans. Furthermore, the Secretary of Health and Human Services is directed to issue guidance by January 1, 2028, for group health plans, health insurers, and Medicare Advantage organizations. This guidance will standardize the provision of information on plan benefits and coverage in a plain English format . Key aspects to be covered include monthly premiums, annual deductibles, out-of-pocket maximums, provider network types, the plan's share of total allowed costs, and standard cost-sharing amounts for various types of care such as primary, specialist, and emergency services. Additional features like wellness programs and eligibility for health savings accounts will also be included, ensuring consumers receive clear and comparable information.
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Timeline
Jun 23, 2026
Introduced in House
Jun 23, 2026
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Jun 23, 2026
Referred to the Subcommittee on Health.
Jun 25, 2026
Forwarded by Subcommittee to Full Committee by Voice Vote.
Jun 25, 2026
Subcommittee Consideration and Mark-up Session Held
  • June 23, 2026
    Introduced in House


  • June 23, 2026
    Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.


  • June 23, 2026
    Referred to the Subcommittee on Health.


  • June 25, 2026
    Forwarded by Subcommittee to Full Committee by Voice Vote.


  • June 25, 2026
    Subcommittee Consideration and Mark-up Session Held

Health

Premium Transparency Act

USA119th CongressHR-9397| House 
| Updated: 6/25/2026
The Premium Transparency Act seeks to increase accountability and transparency within the health insurance industry by requiring detailed public disclosure of financial information from health insurers and Medicare Advantage plans. Starting January 1, 2027, health insurance issuers offering group or individual coverage must submit and publish on their websites the percentage of total premium revenue spent on claims, quality improvement, and administrative costs, along with the percentage of revenue they retain. Similarly, Medicare Advantage organizations will be required to disclose their total revenue, the amounts and percentages spent on incurred claims and non-claims costs, and the difference between their Medical Loss Ratio (MLR) numerator and denominator. This bill also mandates that health insurance Exchanges incorporate this newly required financial data into their comparative information for qualified health plans, starting with plan years beginning on or after January 1, 2029. This aims to provide consumers with more comprehensive data when selecting health plans. Furthermore, the Secretary of Health and Human Services is directed to issue guidance by January 1, 2028, for group health plans, health insurers, and Medicare Advantage organizations. This guidance will standardize the provision of information on plan benefits and coverage in a plain English format . Key aspects to be covered include monthly premiums, annual deductibles, out-of-pocket maximums, provider network types, the plan's share of total allowed costs, and standard cost-sharing amounts for various types of care such as primary, specialist, and emergency services. Additional features like wellness programs and eligibility for health savings accounts will also be included, ensuring consumers receive clear and comparable information.
View Full Text

Suggested Questions

Get AI-generated questions to help you understand this bill better

Timeline
Jun 23, 2026
Introduced in House
Jun 23, 2026
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Jun 23, 2026
Referred to the Subcommittee on Health.
Jun 25, 2026
Forwarded by Subcommittee to Full Committee by Voice Vote.
Jun 25, 2026
Subcommittee Consideration and Mark-up Session Held
  • June 23, 2026
    Introduced in House


  • June 23, 2026
    Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.


  • June 23, 2026
    Referred to the Subcommittee on Health.


  • June 25, 2026
    Forwarded by Subcommittee to Full Committee by Voice Vote.


  • June 25, 2026
    Subcommittee Consideration and Mark-up Session Held
August Pfluger

August Pfluger

Republican Representative

Texas

Cosponsors (3)
Robert J. Wittman (Republican)Nathaniel Moran (Republican)Craig A. Goldman (Republican)

Ways and Means Committee, Health Subcommittee, Energy and Commerce Committee

Health

  • Introduced
  • In Committee
  • On Floor
  • Passed Chamber
  • Enacted