Here in Wyoming, we have the unenviable distinction of facing some of the highest healthcare costs in the region. According to data from the Kaiser Family Foundation, Wyoming residents’ per capita healthcare expenditures in 2020 were roughly 50% higher than in neighboring Utah.
Recent legislation that would have helped Wyoming residents save money on their healthcare bills and put downward pressure on prices died in the Wyoming State Senate. The culprits? Fifteen Republicans (and one Democrat), who sided against Wyoming residents. Instead, they chose some of the largest healthcare providers in the state.
HB 121, the “Hospital Price Transparency Act,” would have required hospitals to maintain and make public a list of standard charges for items and services—something most businesses already do. The legislation also would have prohibited hospitals that didn’t post their prices from sending unpaid bills to collections and authorized the Wyoming Department of Health to suspend, revoke, or deny noncompliant hospitals’ operating licenses.
The House passed the bill 58-3, but it failed narrowly in a 16-14 vote in the Senate. Republican State Rep. Daniel Singh sponsored HB 121, saying, “If you go to the grocery store, you’re not going to check out eggs and not know directly how much you’re paying for the eggs, right? There may be variance in prices, right? But everyone has to be upfront about how much the eggs cost.”
For most of us, this is common sense. Who could disagree that we benefit when we know the prices we pay for goods and services?
If you want to know why someone might oppose legislation like HB 121, just look at who stands to lose if the status quo changes.
Tellingly, the Wyoming Hospital Association (WHA) opposed the measure—and rallied its representatives to sink it. WHA President Eric Boley had the gall to blame Wyoming residents, saying “consumers aren’t working with their insurance companies. They’re not finding out what their payments are.” This is classic blame-shifting. Why should consumers have to go through a third-party to find out the price of basic medical services? That’s not how commerce works in most other areas of modern life. Boley also suggested a state-level law was unnecessary, saying, “I find it interesting that we want to pass additional laws when we already have federal laws in place.”
Although a federal law does require that hospitals post their prices, a 2024 Patients Rights Advocate (PRA) study of 2,000 hospitals found that 66% were out of compliance—an increase from the previous year’s report. Of the four Wyoming hospitals whose websites PRA studied in 2024, 75% were out of compliance. Indeed, hospitals across the country have dragged their feet in response to federal price transparency mandates. One hospital chain in Texas, for example, outright refused to comply in 2021, shortly after new requirements went into effect, saying a list of prices would only benefit its competitors (the chain eventually acquiesced).
State laws like HB 121 are necessary because broad federal mandates alone haven’t been sufficient to motivate compliance. Additionally, HB 121 was tailored to Wyoming’s healthcare system. The genius of federalism is that the people closest to the problem are often in the best position to know how to do something about it.
Contrary to the WHA, whose members benefit from the present state of affairs, there are compelling reasons for Wyoming families to support laws like HB 121.
For starters, the healthcare system has become such a thick tangle of state and federal regulations that few consumers ever know the actual costs their insurance covers. That makes it hard for consumers to know if they’re getting the best value for their money. Austrian economist F.A. Hayek won the 1974 Nobel Prize in Economic Science for his insight into the crucial role prices play in coordinating economic activity. New York University law professor Richard Epstein writes, “Hayek’s basic insight is that prices and markets facilitate selective communications among individuals and thus overcome the fundamental barrier of ignorance, one transaction at a time.”
When it comes to the healthcare market today, the absence of transparent pricing perpetuates consumer ignorance, preventing individuals and families in Wyoming from comparison shopping and holding hospitals accountable for shady practices like overbilling.
Another benefit of price transparency is that it promotes competition among healthcare providers, helping to bring prices down. Currently, hospitals and other providers lack a strong incentive to compete for patients on price. Hospitals often get away with charging insurance companies wildly different prices for the same services, and patients are none the wiser. A 2021 New York Times investigation found that a hospital in Florida charged anywhere from $262 to $2,455 for the same M.R.I., while a hospital in Pennsylvania billed between $10 and $93 for a pregnancy test, depending on insurance plans. It is no surprise, then, that healthcare costs in Wyoming continue to go up, up, up.
Although the number of academic studies on hospital price transparency laws is limited so far, the evidence we do have suggests they work to reduce prices. A 2023 economic analysis estimated the country could save up to $80 billion by 2025 if providers fully complied with all federal transparency rules. The authors write that “across the American health care delivery system, incentives are misaligned, a significant bureaucratic paperwork exists, the true cost of care delivery is unknown, and prices from a patient point of view are shrouded in mystery”—and they hold up price transparency as an obvious policy for beginning to address those problems.
Other states, blue and red alike, are beginning to get the picture. In 2024, Oklahoma Gov. Kevin Stitt (R) signed legislation similar to HB 121 that requires providers to post prices for common procedures and blocks them from pursuing medical debt claims when they don’t. The bill received bipartisan support in both chambers of Oklahoma’s legislature. Minnesota enacted a law last year that sets standards for how hospitals publish their prices, making it easier for consumers to find and compare costs across providers.
It’s no surprise that the country is seeing a bipartisan push for transparency in healthcare costs. A 2023 poll found that 85% of Americans, including an equal number of Republicans and Democrats, support legislation that strengthens price transparency, so consumers can shop around.
President Donald Trump (R) knows what Wyoming state Sens. Eric Barlow (R), Barry Crago (R), and others apparently don’t—that price transparency is good for consumers. That’s why Trump recently signed “Making America Healthy Again by Empowering Patients with Clear, Accurate, and Actionable Healthcare Pricing Information,” an executive order directing the Secretary of Health and Human Services to enforce price transparency laws in hospitals and healthcare plans.
Trump’s executive order is welcome, of course, but as previous experiences with federal hospital price transparency efforts show us, states will need to lead the charge if we want to see real, sustained savings on our healthcare bills. HB 121 was an opportunity for Wyoming lawmakers to side with ordinary residents and shed light on an opaque pricing system. Regrettably, 16 senators voted against the public interest to keep Wyoming families in the dark.
But Wyoming families deserve better. If our representatives won’t stand up to special interests, then it’s up to us to stand up to them at the ballot box, in public forums, and in every conversation about our healthcare system. When lawmakers choose powerful lobbies over the people they represent, they forfeit our trust—and we should remember it.