New rules the Trump administration issued Friday would require insurers and hospitals to disclose upfront the actual prices for common tests and procedures to promote competition and push down costs.

The sweeping changes face stiff pushback from the healthcare industry. A coalition of major hospital groups quickly announced that hospitals will sue to block key provisions, which regardless don’t take effect immediately.

Even in an ideal world where information flows freely, patients and their families would have to deal with a learning curve to get comfortable with the byzantine world of healthcare billing. What sounds like the same procedure can have different billing codes depending on factors that may not be apparent to an untrained person.

Speaking at a White House event, President Trump skipped over potential difficulties, at times making it sound like openness in healthcare pricing was a done deal.

“After many years, we will have transparency,” Trump said. “Within about 12 months I think it will be fully implemented.” He predicted “a tremendous impact on prices.”

A final rule issued Friday would apply to hospitals, and a proposed regulation would apply to insurance plans. Disclosure requirements for hospitals would not take effect until 2021; for insurers, the timing is unclear. The requirements do not directly affect doctors.

Officials say the rules would shine a spotlight on the confusing maze of healthcare prices, enabling informed patients to find services at the lowest cost. Prices for an MRI scan, for example, can vary by hundreds of dollars depending on where it’s done.

“American patients have been at the mercy of a shadowy system with little access to the information they need to make decisions about their own care,” Health and Human Services Secretary Alex Azar said, pointing out that many hospital procedures are scheduled in advance, and that gives patients a chance to shop around.

Under the administration rules, insurers would have to provide patients with online access to individualized estimates, in advance, for what they would owe out-of-pocket for covered services. Most people now see such information after the fact, when their “explanation of benefits” form arrives in the mail.

Insurers and hospitals say the push for disclosure goes too far. They say the government would force them to publicly disclose rates they negotiate as part of private contracts that normally are beyond the purview of authorities.

“This rule will introduce widespread confusion, accelerate anticompetitive behavior among health insurers, and stymie innovations,” the American Hospital Assn. and three other major hospital groups said in a statement. “Our four organizations will soon join with member hospitals to file a legal challenge to the rule on grounds including that it exceeds the administration’s authority.”

Insurers also contend the plan could backfire, prompting relatively low-cost providers to try to raise their prices when they see that others are getting more.

Azar dismissed such criticism. “Point me to one sector of the American economy where having price information in a competitive marketplace actually leads to higher prices,” he said.

With the hospital industry going to court, it could be a long time before consumers see changes.

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For hospitals, the rule would require publication in a consumer-friendly manner of negotiated rates for the 300 most common services that can be scheduled in advance, such as a knee replacement, a Cesarean-section delivery or an MRI scan. Hospitals would have to disclose what they’d be willing to accept if the patient pays cash. The information would be updated every year.

It also would require hospitals to publish all their charges in a format that can be read on the internet by other computer systems. This would enable web developers and consumer groups to come up with tools that patients and their families can use.

For insurers, the rule would require creating an online tool that policyholders can use to get a real-time personalized estimate of their out-of-pocket costs for all covered healthcare services and items, including hospitalization, doctor visits, lab tests and medicines.

It also would require insurers to disclose online the rates they negotiate for in-network providers, as well as the maximum amounts they would pay to an out-of-network doctor or hospital.

The disclosure requirements would carry out an executive order Trump signed this summer.

Sen. Elizabeth Warren explained Friday how she plans to gradually move the United States into her government-run “Medicare for all” system, sending managed-care and hospital stocks higher as the Democratic presidential candidate mapped out her three-year design to fundamentally change the way Americans get healthcare coverage.

Warren said in a Medium post Friday that she would ask Congress to use a legislative maneuver to put children and poor families under Medicare for all in her first 100 days in the White House, and that she would not fully implement her $20.5-trillion plan until her third year in office.

Managed-care and hospital stocks rallied, leading the S&P 500 Health Index to an all-time high Friday. Shares of some of the nation’s largest insurers, including UnitedHealth Group Inc., Humana Inc., Anthem Inc. and Centene Corp., climbed more than 5%.

The healthcare stocks’ jump is a turnaround from the first nine months of the year, when the industry trailed most of its market peers over drug-pricing regulations and Medicare for all proposals.

Warren would need Democratic majorities in the House and Senate to achieve her plan.

She said she would ask Congress to use a quirk in the budget process to allow a simple majority vote — bypassing the 60-vote Senate threshold — and “fast-track” a Medicare for all option that would immediately cover children under 18 and families making less than $51,000 a year, and provide an option for expanded Medicare for people over 50.

In the first three years, anyone else could buy into Medicare for all at a “modest” cost, Warren said, before it eventually became free.

By her third year in office, Warren said, “the American people will have experienced the full benefits of a true Medicare for all option, and they can see for themselves how that experience stacks up against high-priced care that requires them to fight tooth-and-nail against their insurance company.”

She added, “I won’t hand Mitch McConnell a veto over my healthcare agenda,” referring to the current Senate majority leader.

After repeated questioning about how she would finance a government-run Medicare for all system that eliminates private insurance, Warren on Nov. 1 rolled out a $20.5-trillion proposal funded by taxing the rich and large corporations.

Her gradual implementation “will give people time to adjust, people in the industry will have time to look for other jobs, pension plans will have time to start changing their portfolio, and it will give the government time to gear up the bureaucracy,” said Gerald Friedman, professor of economics at the University of Massachusetts at Amherst, who consulted Sen. Bernie Sanders’ 2016 presidential campaign on Medicare for all, the basis of Warren’s plan.

The new proposal sets Warren apart from Sanders, who is running for president again and has said he wouldn’t compromise with incremental healthcare changes.

But Friedman cautioned that a long transition period could leave the private health insurance industry in shambles.

“If you know that in three years your company is going to be wiped out, then it could create perverse incentives, staff start exiting, and companies may become dysfunctional before the government program is set up,” Friedman said.

Warren’s new proposal at least at first looks much like those of her moderate rivals, Joe Biden and Pete Buttigieg: expanded government-run insurance without mandating it for everyone.

Representatives for Biden and Buttigieg quickly weighed in.

“Sen. Warren is now trying to muddy the waters even further,” said Biden deputy campaign manager Kate Bedingfield. “We’re not going to beat Donald Trump next year with double talk on healthcare.”

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Buttigieg spokeswoman Lis Smith said, “Sen. Warren’s new healthcare ‘plan’ is a transparently political attempt to paper over a very serious policy problem, which is that she wants to force 150 million people off their private insurance — whether they like it or not.”

Even if Democrats control the entire federal government in 2021, their best-case scenario is a narrow Senate majority that would likely leave Warren far short of the votes to pass Medicare for all. And several key Democrats have pledged not to eliminate the legislative filibuster. But the party is more united around the idea of a government-run insurance option.

The budget fast-track process, known as reconciliation, has been used by majorities in both parties to avoid a filibuster. Democrats under then-President Obama used it to pass Obamacare in 2010. Republicans under President Trump tried to use the procedure to repeal the healthcare law in 2017 but came up short.

“While Republicans tried to use fast-track budget reconciliation legislation to rip away health insurance from millions of people with just 50 votes in the Senate, I’ll use that tool in reverse — to improve our existing public insurance programs,” Warren wrote.

Still, budget reconciliation creates complications as Senate rules require that such legislation be limited to changes involving taxes and spending. Republicans struggled to shoehorn their attempted repeal of Obamacare, which included regulatory reforms, into the process.

Warren also vowed to take immediate action to lower drug prices in her first day as president, including on insulin, EpiPens and drugs that save people from opioid overdoses. A Warren administration would help companies produce expensive medicines as a price-control measure and use administrative authority to ensure sufficient supply.

It seems everywhere he goes these days, Apple CEO Tim Cook is out there forcefully and publicly defending his company’s decision to provide iPhone users with end-to-end text messaging and FaceTime encryption to protect against the constant threat of criminal hackers and foreign governments. The question is: when will other tech company leaders follow his lead?

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If we’re going to avoid having a horrible law banning encryption passed in the next year, more of the tech company giants’ high-profile representatives – the Mark Zuckerbergs, Marissa Mayers and Eric Schmidts – need to use their platforms as the world’s most well-known technology chiefs to make crystal clear how important encryption is to users everywhere.

US and UK officials have not let up on their months-long PR blitz villainizing encryption in an attempt to force tech companies to provide a surveillance backdoor into their products. This, despite the fact that officials still haven’t produced any evidence that encryption was involved in the planning of any of the recent attacks in Paris and San Bernardino.

Not that it should matter; even if terrorists do use encrypted communications apps there are plenty of ways to track them and plenty of reasons to still encourage the technology’s use. On 60 Minutes earlier this week, Cook explained why encryption is so important and why installing backdoors for government access to everyone’s communications is such a bad idea:

Here’s what the situation is on your smartphone today, on your iPhone, there’s likely health information, there’s financial information. There are intimate conversations with your family, or your co-workers. There’s probably business secrets and you should have the ability to protect it. And the only way we know how to do that, is to encrypt it. Why is that? It’s because if there’s a way to get in, then somebody will find the way in. There have been people that suggest that we should have a back door. But the reality is if you put a back door in, that back doors for everybody, for good guys and bad guys.