Healthcare stays expensive because the system hides prices and quality from the people paying for care, especially employers. We talk with Katie Talento about how CAA 2026 transparency and Department of Labor fiduciary rules could expose PBM practices, reshape contracting, and give plan sponsors real leverage if enforcement follows.• Why invisible prices and invisible quality break the healthcare market • How incentives and lobbying protect opacity across hospitals, PBMs, insurers and drugmakers • Why Washington lacks ERISA and employer-plan expertise • What CAA 2026 changes for PBM disclosures and fiduciary responsibility • How “check the box” compliance can fail without enforcement • How employers can use machine readable files plus claims data for network analysis • Why cash-pay and direct contracting get blocked by network contract provisions • What near-term reforms could bend the cost curve, including stronger HSA and ICHRA modelsYou can find me at katytolento.com