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HR 9397 119th Congress · House

Health Insurer Transparency and Accountability Bill

Advocate

Official title: To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to ensure health insurer accountability through publishing of overhead costs and claim payments, and to direct the Secretary of Health and Human Services to issue guidance on the provision of certain insurance information.

This bill would require health insurers to publish information about overhead costs and claim payments, creating a clearer picture of how premiums are being used. It also directs the Secretary of Health and Human Services to issue guidance on the provision of certain insurance information, which would shape what data consumers and regulators can see. The bill would affect private health insurers and Medicare-related coverage, with the goal of making plans more accountable to patients and policymakers. Its core mechanism is transparency: more disclosure, more standardized information, and more federal guidance on how insurers present that information.

  • Requires insurers to publish overhead costs
  • Requires disclosure of claim payments
  • Directs HHS to issue guidance on insurance information
  • Applies to provisions in title XXVII of the Public Health Service Act
  • Touches Medicare-related rules under title XVIII of the Social Security Act
Public Relevance 45 / 100
Niche Notable impact Broad

For most people with private insurance or Medicare coverage, this bill would not change benefits or premiums right away, but it could make insurer spending more visible and easier to compare. If you shop for coverage, use employer-sponsored plans, or rely on Medicare, the main practical effect would be better information about how much of a plan’s revenue goes to claim payments versus overhead. That could help consumers and purchasers pressure insurers for better value, while also creating more disclosure work for insurers.

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Bill
HR 9397
Congress
119th Congress
Official title
To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to ensure health insurer accountability through publishing of overhead costs and claim payments, and to direct the Secretary of Health and Human Services to issue guidance on the provision of certain insurance information.
Policy area
Healthcare
Latest action
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)
Last updated
June 24, 2026
FOR
  • health care consumers Consumers want a clearer breakdown of where premium dollars go. Public reporting on overhead and claim payments can make it easier to compare plans and spot insurers that spend unusually little on actual care.
  • employers and plan sponsors Employers that buy coverage on behalf of workers often want more transparent plan data. Standardized information can improve bargaining power and help them choose plans that deliver better value.
  • patient advocacy and transparency groups Greater disclosure can improve accountability without directly limiting access to coverage. Supporters argue that if insurers are using premiums efficiently, they should have no problem showing the numbers.
AGAINST
  • health insurers Insurers may argue that new reporting rules add administrative costs and can oversimplify complex plan finances. They may also contend that raw overhead numbers can be misleading unless they are defined and standardized carefully.
  • insurance brokers and benefit administrators These stakeholders may worry that additional disclosure requirements create compliance burdens and confusion for consumers if the data are not presented in a practical, comparable format.
  • some employer groups Employers could see the bill as another federal reporting mandate that increases operational complexity. They may prefer existing market tools over new government-prescribed disclosures.
  • "publishing of overhead costs and claim payments"

    Insurers would be pushed to make two of the most important spending categories more visible. That can help consumers and regulators compare plans, but it also raises questions about how those categories are defined and whether insurers can present them in a way that is easy to understand.

  • "direct the Secretary of Health and Human Services to issue guidance"

    HHS would have a role in shaping how insurers provide information. This matters because guidance can determine whether disclosures are consistent across plans or vary in ways that make comparison difficult.

  • "title XXVII of the Public Health Service Act"

    This points to health insurance market rules that apply broadly in private coverage settings. Changes here can affect plan transparency for many employer and individual market enrollees.

  • "title XVIII of the Social Security Act"

    This indicates the bill also reaches Medicare-related insurance administration. Seniors and other Medicare beneficiaries could see more standardized insurer information if the measure is implemented.

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.

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