COLUMN: Carbaugh: Indiana is making progress on healthcare costs, but more work remains

For many Hoosiers, healthcare costs continue to strain household budgets and create challenges for employers working to provide affordable care.

Rising hospital prices have driven up costs for families and businesses across the state. Those costs often translate into higher insurance premiums and increased out-of-pocket expenses.

A RAND study found that Indiana hospital facility prices averaged 329% of Medicare rates, ranking fourth highest in the nation. That reality has made healthcare affordability a major focus for the General Assembly in recent years, with the goal of bringing greater transparency and accountability to Indiana's healthcare system to lower costs for patients.

In 2025, we took an important step forward by passing House Enrolled Act 1004, a law I authored, to strengthen pricing transparency and establish clear expectations for nonprofit hospital systems. The law reflects a straightforward principle: hospitals receiving benefits of a nonprofit status should provide meaningful value and affordable healthcare to the communities they serve.

Prior to reforms, patients often had limited visibility into the cost of care until receiving a bill, employers had few tools to compare pricing across providers and lawmakers lacked the data needed to evaluate whether nonprofit hospitals were delivering sufficient public benefit in exchange for their nonprofit status. House Enrolled Act 1004 aimed to change that by requiring the state to establish average pricing benchmarks for hospital services, increasing public reporting requirements and directing nonprofit hospital systems with more than $2 billion in revenue to align their prices with those benchmarks by 2029 or risk losing their nonprofit status.

Indiana has also expanded tools to help Hoosiers better understand and compare healthcare prices. Established in 2020, the Indiana All Payer Claims Database has been updated and expanded under a new name – Indiana Health Prices. The platform includes prescription pricing tools, hospital cash prices and nearly 2 billion healthcare claims records from insurers and other sources. It is designed to help Hoosiers compare costs across providers and better understand what they may pay for care, whether using insurance or paying cash.

Recent state reports show encouraging progress. All five of Indiana's largest nonprofit hospital systems met the state's pricing benchmark and complied with new direct-to-employer contracting requirements designed to provide more affordable options for businesses and workers.

These five hospital organizations represent nearly half of Indiana's hospital market, making that progress significant for Hoosier families and employers statewide.

Indiana's efforts align with a broader national focus on hospital pricing transparency and affordability, as policymakers and regulators continue examining how costs are set and disclosed across healthcare systems.

This is meaningful progress, but the work is not finished.

Indiana is committed to maintaining our reputation as one of the best places in the country to start a business, grow a career and raise a family. Affordable healthcare is essential to maintaining that competitive advantage.

Hospitals and healthcare workers play a vital role in our communities. Continued evaluation of pricing, transparency and system-wide value will be important to ensure the incentives nonprofit hospital receive align with the level of community benefits they provide.

The progress we've seen so far demonstrates that transparency and accountability can move Indiana in the right direction.

Hoosiers deserve a healthcare system that delivers high-quality care at a price families, workers and employers can afford. I remain committed to that goal and will work with my colleagues at the state and federal levels to make Indiana a national leader in public health.

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State Rep. Martin Carbaugh (R-Fort Wayne) represents House District 81,
which includes a portion of Allen County.
Click here to download a high-resolution photo.