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The government of Donald Trump warned on Wednesday that more than 500 hospitals in the United States must publish clear information about their healthcare prices or face penalties of up to 2 million dollars annually per institution.
The list of medical centers that since April have received warning letters or requests to submit disclosure plans was exclusively obtained by The Associated Press.
A senior government official, who requested anonymity, confirmed that Trump plans to tighten regulations under an executive order he signed in 2019, and that more hospitals may receive similar letters.
The problem that the measure aims to correct
The stated objective is to address a structural issue in the U.S. healthcare system: that patients, employers, and insurers often do not know in advance how much common procedures, such as a blood test or an X-ray, will cost.
According to the administration, this lack of transparency directly contributes to inflating medical costs, which can devastate a family's budget.
The administration wants suppliers to provide access to pricing files and ensure that the information is legitimate, rather than relying on estimates or omitting key figures.
The states and hospitals in the spotlight
Texas tops the list with 42 hospitals that received warnings, more than any other state. Among them are the Baptist Medical Center in San Antonio - one of the largest in the state, with 1,585 beds - and the University of Texas MD Anderson Cancer Center in Houston.
Indiana has reported 34 hospitals, a striking figure considering that California - with five times the population - had only 38.
The Ascension system, based in Missouri and one of the largest in the country, had 13 hospitals in several states that received letters.
Government officials specifically stated that the Christiana Hospital in Delaware, the home state of former President Biden, also received a warning letter.
An agenda with background and criticisms
The regulatory foundation of this action traces back to the Executive Order 13877, signed by Trump in June 2019, which directed the Department of Health to propose rules requiring hospitals to disclose their standard rates, including the rates negotiated with insurers.
The rule came into effect on January 1, 2021, but compliance was weak: an audit by the Inspector General of the Department of Health in 2024 found that only 46% of the 5,879 hospitals required were in compliance with the standard.
In his second term, Trump has expanded the agenda for reducing healthcare costs.
In February 2026, Trump launched TrumpRx, a site for purchasing prescription medications at reduced prices.
In November 2025, Medicare announced price reductions for 15 high-cost medications, including Ozempic, which would see its price decrease from $959 to $274, effective in 2027.
However, the administration is facing criticism for allowing the extended subsidies under the Affordable Care Act—known as Obamacare—to expire at the end of 2025, which could have doubled premiums for millions of insured individuals.
According to the latest AP-NORC poll, only 29% of adults in the United States approve of Trump's healthcare policies, his lowest rating among major government issues.
Hearing in Congress
The House Energy and Commerce Committee held a hearing on health price transparency this Wednesday, where bills such as the Lower Costs, More Transparency Act of 2026 and a proposal for hospitals to publish their prices on the walls of their facilities were discussed.
Shawn Gremminger, executive director of the National Alliance of Healthcare Purchaser Coalitions, supported the initiative: "Transparency is the foundation of a healthcare system that rewards competition based on cost and quality."
The administration has estimated that its combined cost-cutting measures could yield savings of over $500 billion over ten years, although critics warn that these figures do not always translate into actual savings for insured patients.
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