White House Report: Banning Anti-Competitive Hospital Contracts Could Yield $45B in Annual Premium Savings

A June 18, 2026, analysis from the White House Council of Economic Advisers estimates that prohibiting three common types of hospital-insurer contract clauses—anti-steering, anti-tiering, and all-or-nothing bundled agreements—could lower hospital and physician prices by 18% in affected markets, translating to roughly $4,100 less per inpatient admission. The report projects nationwide employer-sponsored insurance premium reductions of about 1.6%, or $45 billion annually (with a range of $29–63 billion), primarily benefiting workers through lower contributions and higher take-home pay. These clauses, which critics argue insulate dominant hospital systems from competition, restrict insurers' ability to steer patients to lower-cost providers, place systems in less favorable network tiers, or negotiate with individual facilities rather than entire networks. The administration frames the proposal as a market-oriented reform avoiding price controls, with parallel efforts including DOJ antitrust actions, such as the recent suit and proposed settlement with OhioHealth over similar restrictions. Bipartisan legislation like the Healthy Competition for Better Care Act, reintroduced by Rep. Jodey Arrington (R-TX) and others, seeks to codify such bans federally. Several states, including Connecticut, Massachusetts, and Texas, already limit certain provisions with varying enforcement. While the savings estimates rely on assumptions about bargaining leverage gains (approximately 8%), patient steering efficiencies (4%), and long-term competitive dynamics (3%), they highlight how concentrated provider markets contribute to broader healthcare cost pressures affecting millions of Americans through employer plans.