H.R.2041 - Hidden Fee Disclosure Act of 2025 (119th Congress)
Summary
H.R.2041, the Hidden Fee Disclosure Act of 2025, aims to amend the Employee Retirement Income Security Act of 1974 (ERISA) to enhance transparency in employer-sponsored health plans. The bill focuses on clarifying and strengthening disclosure requirements for covered service providers, particularly concerning pharmacy benefit management (PBM) services and third-party administrators (TPAs). It mandates more detailed disclosures of fees, rebates, and other forms of compensation received by these service providers.
Expected Effects
The Act will likely lead to increased scrutiny of fees and compensation within employer-sponsored health plans. This increased transparency is intended to empower plan fiduciaries to make more informed decisions. Ultimately, the goal is to reduce hidden fees and ensure that plan sponsors and beneficiaries receive better value for their healthcare dollars.
Potential Benefits
- Increased transparency in healthcare costs, allowing employers and employees to understand where their money is going.
- Greater accountability for PBMs and TPAs, potentially leading to lower costs for prescription drugs and administrative services.
- Empowered plan fiduciaries with the information needed to negotiate better contracts and reduce conflicts of interest.
- Improved ability for plan sponsors to compare different service providers and choose the most cost-effective options.
- Enhanced consumer protection by ensuring that patients are not overcharged for prescription drugs or other healthcare services.
Most Benefited Areas:
Potential Disadvantages
- Increased administrative burden for covered service providers, potentially leading to higher compliance costs.
- Potential for unintended consequences, such as reduced competition among PBMs and TPAs if disclosure requirements are too onerous.
- Risk that the disclosed information may be difficult for plan fiduciaries to interpret and use effectively.
- Possibility that service providers may find ways to circumvent the disclosure requirements.
- Potential for increased litigation as plan sponsors and beneficiaries seek to recover hidden fees.
Constitutional Alignment
While the Constitution does not explicitly address healthcare or employee benefits, Congress's authority to regulate these areas stems from the Commerce Clause (Article I, Section 8). This clause grants Congress the power to regulate interstate commerce, which includes the provision of healthcare services and the administration of employee benefit plans that operate across state lines. The Act's focus on transparency and disclosure aligns with the general principle of promoting fair and efficient markets, which is a legitimate goal under the Commerce Clause.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).