HR 9228: Health Data Access, Transparency, and Affordability Act of 2026

HR 9228 in plain English: The bill establishes rules around health data access, transparency, and affordability, and creates a civil penalty of up to $10,000 per day for violations by covered persons or entities.

Stated purpose

The bill aims to ensure that the people responsible for managing employer-sponsored health plans (called plan fiduciaries) have full access to detailed, de-identified health claims data from insurers, pharmacy benefit managers, and other service providers. It does this by requiring that any service contract with the health plan allow this data access as a condition of being considered a legal and reasonable arrangement under federal law.

Key points

• Imposes civil penalties of up to $10,000 per day on persons or entities that violate the bill's requirements.
• Addresses health data access, transparency, and affordability standards.

Arguments supporters make

• Employers who pay for health benefits deserve to see exactly how their money is being spent, and this bill gives them the tools to spot waste, fraud, and overcharging.
• Greater transparency in pricing and claims data could help plan managers negotiate better deals and lower costs for both employers and the workers they cover.
• Insurers and middlemen have long kept pricing and payment data secret; this bill levels the playing field so plan fiduciaries can actually fulfill their legal duty to act in members' best interests.

Arguments opponents make

• Requiring broad data sharing — even de-identified — raises real privacy concerns for workers, especially in small firms where individuals could potentially be re-identified from their claims data.
• Insurers and pharmacy benefit managers may argue that forcing disclosure of proprietary pricing formulas and contract terms undermines their negotiated arrangements and could ultimately raise costs or reduce network options.
• The bill's enforcement mechanism — making contracts legally invalid if they restrict data access — could create significant contract disputes and administrative burdens for plans, vendors, and courts without a clear process for resolving disagreements.

Tradeoffs

The bill trades some degree of insurer and vendor contractual privacy for greater employer oversight and potential cost savings, meaning any gains in plan transparency and accountability come with tradeoffs around proprietary business information and the complexity of ensuring sensitive health data is truly protected when shared more widely.

Current status in Congress: In committee.

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