Health plans gain pricing power; employees' benefit depends on sponsor action.

What it does

This bill amends ERISA to require health plan fiduciaries (the people managing employee health plans) to have access to detailed claims data, pricing information, and payment details from network service providers—insurers, administrators, pharmacies, and other contractors. It bans contractual clauses that delay or limit this access beyond 15 days, prohibits gag clauses that hide pricing or audit rights, and imposes up to $10,000-per-day civil penalties on service providers who violate these rules. Plan sponsors and fiduciaries gain transparency into what they're paying for and can audit for overpayments and fraud.

Why we flagged it

The bill's core mechanism is a data-access mandate: it strips away contractual gag clauses and access delays that had prevented plan fiduciaries from seeing claims, pricing, and payment data. The operative effect is to shift information power from service providers (insurers, TPAs, PBMs) to plan sponsors and fiduciaries, enabling audits and cost negotiation.

What the text implies

• Plan sponsors gain access to de-identified claims data but the bill does not restrict how they use it—they could use pricing transparency to shift costs to employees rather than negotiate lower rates with providers.
• The bill mandates disclosure of 'extra-contractual terms' and 'payment methodologies,' which may expose proprietary pricing algorithms and negotiation strategies that service providers have kept confidential; this could reshape competitive dynamics in the health plan administration market.
• Employees are not named as beneficiaries and have no direct right to access the data; transparency flows to plan sponsors and fiduciaries, not workers, so employee benefit depends entirely on sponsor discretion.
• The $10,000-per-day penalty applies to service providers but the bill prohibits indemnification—service providers cannot pass the cost to plans, creating a direct financial exposure for TPAs, PBMs, and insurers that may trigger contract renegotiations or service withdrawals.
• The attestation requirement (annual certification of compliance) creates a new compliance burden on plans and issuers but does not require third-party auditors, leaving enforcement dependent on DOL investigation and civil penalties.

Section numbers refer to the bill text the analysis read — linked under Primary records below.

Who it affects

Employees benefit indirectly if plan sponsors use transparency to negotiate lower rates and detect fraud, reducing plan costs and premiums. However, the bill's primary mechanism empowers plan fiduciaries and sponsors, not employees directly; the employee benefit is contingent on sponsor action. The bill also does not restrict how plans use the data—sponsors could use pricing transparency to shift costs to workers rather than negotiate savings.

Who stands to gain

• health plan sponsors and fiduciaries (gain cost-control and audit leverage)
• self-insured employers (gain direct access to claims data without intermediary gatekeeping)

Named in the bill

Employee Retirement Income Security Act of 1974 (ERISA), Health Insurance Portability and Accountability Act (HIPAA), Third-party administrators (TPAs), Pharmacy benefit managers (PBMs), Health insurance issuers, Network service providers, U.S. Department of Labor (Secretary of Labor), ASC X12N 837 (claims transaction standard), ASC X12N 835 (payment/remittance standard), National Council for Prescription Drug Programs (NCPDP)

Where it stands

2 cosponsors: 2 Republicans.

• Jun 9, 2026 — Introduced · Congress.gov: “Introduced in House”
• Jun 9, 2026 — Referred to House Committee on Education and Workforce · Congress.gov: “Referred to the House Committee on Education and Workforce”
• Jun 25, 2026 — Markup held in committee · Congress.gov: “Committee Consideration and Mark-up Session Held”
• Jun 25, 2026 — Reported out of committee · Congress.gov: “Ordered to be Reported (Amended) by the Yeas and Nays: 18 - 15”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.

Money around this bill

5 lobbying clients named this bill on 5 disclosure filings across 1 quarter, Jun 2026 to Jun 2026. Those filings disclosed $4,325,962 in lobbying spend. A filing names 5 bills on average, so that figure is what each filing reported, not a share belonging to this bill.

More lobbying clients named this bill than 78% of bills with at least one filing.

Robert Onder, the sponsor, reported $438,000 in PAC receipts in the 2026 cycle.

• Pharmaceutical Care Management Association — $3,282,990 on 1 filing
• Planned Parenthood Federation of America Inc — $652,972 on 1 filing
• Chro Association (fka Hr Policy Association) — $270,000 on 1 filing
• Nomi Health, Inc. — $100,000 on 1 filing
• Purchaser Business Group on Health (pbgh) — $20,000 on 1 filing

Lobbying Disclosure Act filings through Jul 20, 2026. A filing shows who paid to lobby on a bill it names, not what changed.