Illustration: Lazaro Gamio/Axios

Hospitals sued the Trump administration yesterday over its requirement that they disclose their negotiated rates, the latest of the industry's moves to protect itself from policy changes that could hurt its revenues.

Why it matters: Hospitals account for the largest portion of U.S. health costs — which patients are finding increasingly unaffordable.

The big picture: Hospitals are going to war against Trump's price transparency push while simultaneously trying to kill Democrats' effort to expand government-run health coverage.

  • The industry is one of the main forces behind the Partnership for America's Health Care Future, the group that's gone on offense against "Medicare for All" and every other proposal that would extend the government's hand in the health system, as Politico recently reported.
  • It's also emerging victorious from blue states' health reforms so far, which all started as proposals much more threatening to hospitals than the watered-down versions that eventually replaced them.

Between the lines: The industry has a lot to lose; even non-for-profit systems, as my colleague Bob Herman put it, "swimming in cash."

  • The Trump administration's transparency measure could lead to either more pricing competition or further regulation, if it exposes egregious pricing practices.
  • And Democrats' proposals often feature government plans that pay much lower rates than private insurance does.

Hospitals argue that the transparency measure could end up raising prices if providers with lower negotiated rates see what their competitors are getting. They also warn that Democrats' plans could put hospitals and doctors out of business and threaten patients' access to care.

The bottom line: Politicians are reacting to patients' complaints about their health care costs, but the industry has historically been excellent at getting its way.

Go deeper: Hospitals winning big state battles

Go deeper

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Data: Business Roundtable; Chart: Naema Ahmed/Axios

A closely-watched CEO economic confidence index rose for the first time after declining for nine straight quarters, according to a survey of 150 chief executives of the biggest U.S. companies by trade group Business Roundtable.

Why it matters: The index, which still remains at a decade low, reflects corporate America's expectations for sales, hiring and spending — which plummeted amid uncertainty when the pandemic hit.

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John Bolton's book "The Room Where it Happened." Photo: Chris Delmas/AFP via Getty Images

A former career official at the National Security Council claims her pre-publication review of former national security adviser John Bolton's explosive book on President Trump was "commandeered by political appointees for a seemingly political purpose," according to a letter from her lawyers filed in court on Tuesday.

Why it matters: The White House fought against the publication of Bolton's book for most of the year on the grounds that it contained harmful and "significant amounts of classified information."

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