Health Data Access, Transparency, and Affordability Act of 2026
Sponsored By: Representative Onder, Robert F. [R-MO-3]
In Committee
Summary
Stronger data access and transparency for employer-sponsored group health plans. The bill amends the Employee Retirement Income Security Act to require broader, faster access to claims, encounter, pricing, and supporting documents and to add new enforcement and attestation rules.
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- Plans and plan fiduciaries gain explicit rights to full claims and encounter information, medical records, pricing formulas, overpayment details, and related documents, with access not delayed beyond 15 days.
- Network service providers, third-party administrators, pharmacy benefit managers, and issuers must stop using contract terms that block or limit data access or auditing, or face new legal exposure.
- Violations can trigger civil penalties of up to $10,000 per day and contract terms that indemnify vendors for such penalties are void as against public policy.
- Group health plans and issuers must submit annual attestations to the Secretary that required information is available on request and explain any barriers if data cannot be obtained.
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 0 benefits, 0 costs, 1 mixed.
More data for employer health plans
If enacted, the bill would require ERISA group health plan vendors to give plan fiduciaries full claims, encounter, pricing, and supporting records. Files must use HIPAA transaction formats and be delivered within 15 days, or faster if the Secretary sets a shorter deadline. Non-claim costs must be itemized and available in real time by web portal, API, or downloadable CSV at no cost to the plan. Plans and issuers would have to file annual attestations with the Secretary of Labor that required data is available. Contracts that block access or try to shield vendors from ERISA penalties would be void, and the Secretary could fine violators up to $10,000 per day. These rules would apply to plan years beginning one year after enactment, even if a contract was signed earlier, and the new penalties and disclosure duties could raise vendor costs and affect plan fees or premiums.
Sponsors & CoSponsors
Sponsor
Onder, Robert F. [R-MO-3]
MO • R
Cosponsors
Rep. Spartz, Victoria [R-IN-5]
IN • R
Sponsored 7/13/2026
Rep. Harshbarger, Diana [R-TN-1]
TN • R
Sponsored 8/3/2026
Roll Call Votes
No roll call votes available for this bill.
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