REP. ONDER'S BILL TO STRENGTHEN TRANSPARENCY IN EMPLOYER-SPONSORED HEALTH PLANS PASSES COMMITTEE

The following information was released by the office of MissouriRep.Bob Onder:

Today, U.S. Congressman Bob Onder (R-MO) released the following statement after his bill, H.R. 9228, the Health Data Access, Transparency, and Affordability Act of 2026, passed out of the Education and Workforce Committee and now awaits consideration on the House floor.

This legislation amends the Employee Retirement Income Security Act of 1974 to ensure plan fiduciaries have access to de-identified information relating to health claims and important data.

"Employers need access to all the information necessary to manage health plans, control costs, and protect workers' benefits. Employer-sponsored health plans often face barriers when trying to obtain critical data and information, which is why my bill, the Health Data Access, Transparency, and Affordability Act of 2026, is so important. It strengthens clarity and accountability in employer-sponsored group health plans by prohibiting service providers, such as third-party administrators, from delaying, restricting, or otherwise limiting access to plan data. As a physician and a Congressman, I am proud to do my part to ensure timely access to the information needed for employers to properly conduct audits and evaluate health plan performance,"said Congressman Bob Onder.

"When employers have access to timely, complete health plan data, they can make smarter decisions and design benefits that best meet the needs of their workforce. H.R. 9228 is a commonsense, transparency-focused measure that gives employers a clearer picture of health care costs. By breaking down these costs, this legislation will drive accountability, reduce waste, and help deliver more affordable, high-quality health care for employees and their families,"said Education and Workforce Committee Chairman Tim Walberg (R-MI).

To read the full bill, click here:H.R. 9228

Background Information

Under current federal law, employers that sponsor self-funded health plans are legally and financially responsible for how employee health care dollars are spent. Yet, in many cases, insurers and third-party administrators (TPAs) deny employers access to the raw claims data needed to verify those costs and ensure plan funds are being used appropriately.

Without that transparency, TPAs and other administrative entities can impose hidden markups on medical procedures and prescription drugs, charging an employer one price, paying the provider or pharmacy a much lower amount, and pocketing the difference. The Health Data Access, Transparency, and Affordability Act would make clear that claims data generated by an employer-funded health plan belongs to the plan itself and the employer paying the bills, not the insurance company or administrator managing the plan.

Recent litigation has highlighted the consequences of this lack of transparency. Below are a few examples:

Kraft Heinz Co. v. Aetna (2023): Kraft Heinz sued Aetna for hiding its raw claims data and providing only "edited" reports. The lawsuit explicitly alleged that Aetna used its leverage to negotiate lower rates with doctors but did not pass those savings back to the employee, instead pocketing the spread between what Kraft was charged and what providers received.

Owens and Minor v. Anthem: Global logistics firm Owens and Minor attempted to audit its health plan to verify accurate billing and eliminate overcharges. Anthem refused to provide line-by-line data, claiming its negotiated hospital rates were "proprietary trade secrets."

Lewandowski v. Johnson and Johnson (20242026): Employees sued Johnson and Johnson for failing to police their plan, proving that employers face significant legal liability if they cannot audit drug costs. Because of a lack of transparency and hidden spread pricing, the JandJ plan paid $10,239 for a generic drug that costs just $28 retail.

The Health Data Act would restore accountability to the employer-sponsored health insurance system by ensuring that those who pay the bills have access to the data necessary to monitor spending, identify waste, and prevent abusive pricing practices.