House committee advances bill letting insured apply lower cash prices to deductibles, requires plan price disclosures

House Bill 16-04, a market-driven price-transparency measure championed by Representative Maguire, won committee approval on a unanimous 11-0 voice vote after an amendment was adopted.

The bill would require health plans to publish the average discounted rates they negotiate with providers and create a clear process for insured people who pay a lower cash price to submit proof so that amount is applied to their deductible. Supporters framed the proposal as a way to let patients “shop” for care and to reward lower-cost providers without reducing patients’ coverage.

Proponents said the bill is modeled on the Cicero Institute’s Patient Right to Save initiative and is already law in several other states. Representative Maguire told the committee the bill “enhances price transparency and incentivizes patients to seek cost-effective care.” Josh Archambault, a senior fellow with Cicero Action, said providers advertising lower cash prices have generated real savings in other states. “Direct-pay pricing is on average 30% less,” Archambault told the committee.

Testimony from business and advocacy groups was mostly supportive but included caveats. Matt Bell of Hoosiers for Affordable Healthcare and Natalie Robinson of the National Federation of Independent Business said the bill would give employees and small employers an additional tool to reduce costs. Ashton Eller, representing the Indiana Manufacturers Association, said his group supports the concept of crediting out-of-pocket cash payments but opposes including ERISA-covered self‑insured plans in the bill’s state mandate, saying the state lacks authority to regulate ERISA plan design and that adding such a requirement could face legal challenges.

Gloria Sachdev, secretary of the Indiana Family and Social Services Administration representing the governor’s office, urged passage and described independent labs such as Any Lab Test Now that publish cash prices and allow consumers to get tests quickly at lower prices. Sachdev said the state’s all-payer claims database could one day improve consumer price shopping and that Hoosiers “should be rewarded for looking up prices.”

Representative Ledbetter asked whether retailers and pharmacies would accept crediting cash payments; Maguire and witnesses said the bill requires plans to publish the submission process and a standardized form, and that proof of payment (not a submitted insurance claim) would be used to qualify the payment for deductible credit. Committee members also asked about administrative burdens; witnesses said plans would post an online form and that the intent is to minimize employer workload.

The committee adopted an amendment on the floor and voted to pass the bill, sending HB 16-04 from committee by a recorded vote of 11-0. The committee’s roll call list for the motion included Representative Campbell, Dan Chesser, Shackleford, Ross Reeves, Layman, Barrett, Borders, Mayfield, Maguire, Ledbetter and Carbaugh.

Supporters said the bill aims to encourage competition among providers, help people with high deductibles afford care and create opportunities for independent providers to attract patients on price. Opponents and cautionary witnesses focused on ERISA preemption for self-insured employer plans and urged careful drafting or exclusion of ERISA plans to avoid legal challenges.

The bill now moves to the full House for further consideration; committee testimony and the amendment text identify implementation details that would require plans to publish guidance on how members submit documentation and how plans will apply cash payments to deductibles.