The Senate Health, Education, Labor, and Pensions (HELP) Committee is scheduled Monday to advance a bipartisan legislative package targeting anti-competitive contracting practices between major hospital systems and commercial health insurers, following the release of a report estimating that a ban on certain exclusive contracts could save Americans up to $45 billion annually.

The legislation, informally titled the Hospital Transparency and Competition Act, would prohibit so-called 'all-or-nothing' and 'most-favored-nation' clauses that critics say allow dominant hospital networks to lock insurers into pricing arrangements that inflate costs for patients. The report, published this week by health policy researchers and cited by HELP Committee Chair Bernie Sanders and ranking members across the aisle, provided the most concrete cost estimate to date, giving lawmakers a concrete figure around which to build consensus.

Advocates from the American Hospital Association are expected to testify in opposition during Monday's markup session, arguing that the contracts in question allow hospitals to offer coordinated, system-wide care and that dismantling them would destabilise reimbursement structures at community hospitals. However, patient advocacy groups, including Families USA and the National Partnership for Women and Families, have submitted written testimony supporting the bill, citing rising out-of-pocket costs and insurance premiums.

Health economists from the Brookings Institution and the Commonwealth Fund are expected to present supplementary analyses during the hearing, reinforcing the $45 billion savings estimate and pointing to precedent in states such as California and Colorado, which have enacted partial restrictions on such contracts with measurable effects on local insurance premiums. Several large self-insured employers, including major retailers and technology companies, have quietly lobbied in favour of the bill through the Business Group on Health.

If the committee advances the bill out of markup on Monday, it would move to the full Senate floor for a vote, likely in late July. The White House has signalled support for the general direction of hospital competition reform, though it has not yet issued a formal Statement of Administration Policy on this specific legislation. Healthcare analysts at SVB Securities noted that the bill's advancement could weigh on shares of for-profit hospital chains such as HCA Healthcare and Tenet Health when markets open Monday morning.