Wyden and Murray Call for Action to Improve Health Data Transparency

All Payer Claims Databases, Weakened by Recent Supreme Court Decision, Are Valuable Tools for Health Care System

WASHINGTON – Senate Finance Committee Ranking Member Ron Wyden, D-Ore., and Senate Health, Education, Labor and Pensions (HELP) Committee Ranking Member Patty Murray, D-Wash., sent a letter to Labor Secretary Tom Perez and Health and Human Services Secretary Sylvia Mathews Burwell relaying concerns about the effect of the recent Gobeille v. Liberty Mutual decision by the Supreme Court, which limited the ability of state all payer claims databases (APCDs) to collect important health care data.

“The lack of transparency in health care makes it nearly impossible to get care based on price and quality,” Wyden said. “New and innovative ways of mapping health care data should not be stifled at the expense of greater affordability and choice. I hope the administration will take every appropriate action to restore state access to this critical data.”

“If we want a health care system that works for patients and puts their needs first, transparency must be a top priority,” Murray said. “It’s critical that we support efforts to give patients, providers, and employers the tools to make informed decisions, and making sure states have access to this data is an important part of our efforts.”

All payer claims databases collect and compile information on the prices paid by public and private insurers for health care. They allow the public to comparison shop for high-value care and make more informed treatment decisions, aid payers in developing new payment models that reward providers who offer high-quality care at lower prices, and help states conduct oversight of insurers’ proposed premium rate filings, among numerous other uses.

The Supreme Court’s recent decision in Gobeille v. Liberty Mutual threatens states’ ability to make use of this data. In Gobeille, the Supreme Court ruled that state laws requiring self-funded employer-sponsored health insurance plans to submit data to the State APCD are preempted by the Employee Retirement Income Security Act (ERISA). That means APCDs can only collect data from employer-sponsored health insurance on a voluntary basis, which is likely to skew data towards Medicare and Medicaid enrollees, which typically represent an older and sicker population of individuals. States should have the option to provide transparency into health care prices from all plan types, not just some.

The letter can be found here.

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