The most important healthcare document released this year wasn’t another regulation, another inspector general report, or another congressional hearing. It was a list of more than 500 hospitals spread across 45 states and the District of Columbia, which the Trump administration identified as failing to comply with the hospital price transparency rule. Five years after Congress required hospitals to disclose what they charge, hundreds still aren’t following the law. So, at this point, we’re no longer debating transparency, we’re debating accountability.

Anyone who has spent time inside a hospital finance department knows these organizations possess extraordinarily sophisticated revenue-cycle systems. They know what Blue Cross pays for an MRI, what Medicare reimburses for a hip replacement, what a self-pay patient owes after meeting a deductible, and how each payer contract differs from the next. The information Congress asked hospitals to disclose isn’t missing. It already exists.