A new report card tracking health care price transparency finds that 45 states failed to offer essential information to consumers shopping in the U.S. health system, a significant step back since easier-to-understand public health solutions were to have become the norm in this post-Affordable Care Act world.

In 2014, not one state received an “A” grade and only Maine and Massachusetts claimed a “B” grade, according to the second annual Report Card on State Price Transparency Laws. The data – compiled by nonprofit organizations Catalyst for Payment Reform and the Health Care Incentives Improvement Institute – signifies a stark contrast to last year’s results, where 14 states were awarded a “C” or better. Also, 72% of the nation fell within the “D” and “F” range last year.

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