Mark Butler (Hindmarsh, Australian Labor Party, Deputy Leader of the House) Share this | Hansard source

I move:

That this bill be now read a second time.

The Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026 will enable Australians to make informed decisions about their health care and private health insurance.

It provides clarity on individual medical practitioner fees and out-of-pocket costs.

It safeguards consumers by outlawing product phoenixing, closing a loophole that allowed private health insurers to close a product and re-open an identical one at a higher price or reduce the value of a product without ministerial scrutiny.

Schedule 1 of the bill focuses on providing consumers with more detailed information on the expected medical fees charged, and likely out-of-pocket costs, for their private health care experience.

An increasing number of Australians are not taking up referrals from their general practitioner to see a specialist due to cost. In 2024-25, 8.6 per cent of people delayed or missed specialist care—that's over 800,000 people—because of cost. The most common cause of out-of-pocket costs is medical specialist fees.

It is unjustifiable to require patients to commit to a medical treatment without knowing what the cost of that treatment will be and without being able to compare those costs against the fees charged by other providers. Understanding the level of support that is provided by their private health insurer is also vital in determining their likely out-of-pocket costs.

To support greater transparency, since 2022, specialists and insurers have had the opportunity to participate in the Medical Costs Finder and publish their fees and out-of-pockets data.

Uptake has been shockingly low with only one to two per cent of specialists and 10 per cent of insurers participating on the website as at December 2025.

Schedule 1 will allow for the publication of the relevant data on the Medical Costs Finder without the need for input from specialists as it will be drawn from Medicare, hospital and insurer billing data already collected by government. While the focus is on the charging practices of non-GP specialists, general practitioners and their billing could also be published on the website in the future.

Schedule 1 will amend the Health Insurance Act 1973 and the Private Health Insurance Act 2007to:

Importantly, the amendments will continue to protect the privacy of consumers, and no patient information will be published.

The Department of Health, Disability and Ageing is establishing an internal review process for medical practitioners to inquire or to request the department to review the fee information that is published about them.

Without passage of this schedule, Australians will continue to have uncertainty about the potential costs of their treatment. Patients will continue to be unable to compare between providers and unable to seek better value from their private health care.

Schedule 2 of the bill relates to changes to strengthen ministerial oversight of private health insurance premiums to better protect consumers.

Currently, private health insurers are required to apply to the minister if they wish to change the premium for an existing product. This has typically occurred once a year through the annual premium round process.

Insurers are not required to seek approval for the premium charged for new products. Some insurers have used this process to circumvent the intent of the premium round by closing an existing product to new members and launching a new but very similar product at a higher price than was authorised by the minister for the existing product.

This process, known as phoenixing, hurts not just new entrants to private health insurance who are directly impacted, but the 15.3 million people who hold private health insurance who are left unprotected from underscrutinised changes.

To address this issue, amendments to the Private Health Insurance Act 2007will require insurers to apply to the minister for approval of the premiums for new and existing products. In addition to requiring ministerial approval for proposed premium changes, insurers will have to apply if they open a new product, or they reduce the cover, a benefit or other term or condition of an existing product.

Additional changes are being made to formalise and enhance existing practices also that occur under the annual premium round process. These include:

These reforms are an important step in holding private health insurers to account and empowering consumers to make informed decisions about the costs of their health care.

The government will always pursue reforms to ensure private health insurance delivers genuine value for money, greater transparency, and puts consumers right at the centre of healthcare decisions.

I commend the bill to the House.

Debate adjourned.

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