Health insurance CEOs grilled on high costs of care in back-to-back House hearings
WASHINGTON — Lawmakers from both sides of the aisle pressed health insurance CEOs on premium hikes, prior authorization rules and claim denials during back-to-back House committee hearings Thursday, focusing on how insurers’ decisions affect patients right now.
The CEOs of UnitedHealth Group, CVS Health Group, Cigna Health Group, Elevance Health and Ascendiun spent the morning testifying before the House Energy and Commerce Committee and traveled to a hearing before the Ways and Means Committee in the afternoon.
The hearings, called by Republicans, come as health insurance premiums have soared for millions of Americans. For those who receive insurance under the Affordable Care Act, the expiration of enhanced subsidies at the end of 2025 has led to a doubling or tripling of premiums in some cases. People with workplace insurance also saw increases, which insurers attributed to the rising cost of prescription drugs and hospital care.
“Millions of Americans across the country have seen their health care premiums skyrocket,” said Rep. Debbie Dingell, D-Mich. “Yet you are all generating record profits.”
“It’s crushing families, it’s a drag on our economy and it’s a threat to my children’s future,” said Rep. Jodey Arrington, R-Texas.
CEOs rejected those criticisms, saying rising premiums reflected higher costs elsewhere in the health care system. They say the insurance industry competes on price and that would have no incentive to raise premiums beyond what people can afford.
“We work every day to lower the cost of healthcare,” said David Cordani, CEO of Cigna.
At the first hearing, Reps. Alexandria Ocasio-Cortez, D-N.Y., and John Joyce, R-Penn., explained how insurance giants have acquired pharmacy benefit managers (PBMs), the middlemen involved in drugs covered by insurance.
CVS Health owns insurer Aetna and CVS Caremark, its PBM. UnitedHealth Group owns UnitedHealthcare, its insurance arm, and Optum, its PBM, which also employs doctors. Cigna, another insurer, owns Express Scripts, a PBM.
In an exchange with CVS Health CEO David Joyner, Ocasio-Cortez said CVS, through Caremark, handles about 30% of all prescriptions filled in the United States.
“Mr. Joyner, this represents some market concentration,” Ocasio-Cortez said.
“I would disagree,” Joyner said. “It’s a model that works really well for the consumer.”
“I think it works really well for CVS,” Ocasio-Cortez joked.
Rep. Buddy Carter, R-Ga., questioned why CVS would have spent $41 million in compensation to Joyner in 2024. “How do you justify being paid that much?” » asked Carter.
Other lawmakers pointed the finger at constituents who were denied coverage.
Rep. Kim Schrier, D-Wa., spoke about a constituent who, she said, was denied hospitalization by UnitedHealth Group following a stroke.
“This is simply unconscionable and shameful,” Schrier told Stephen Hemsley, CEO of UnitedHealth Group, at the same hearing. “This is why so many people hate their insurance company.”
The House hearings were the first in a series expected to examine the “root causes” of high health care costs.
And while criticism of insurance companies was bipartisan, Republicans and Democrats also blamed each other for the crisis, with the Republican Party blaming Obamacare and Democrats accusing Republicans of using the hearings to deflect their own inaction on rising premiums.
“Obamacare prices have only gone up, not down,” Rep. Jason Smith, R-Mo., chairman of the Ways and Means Committee, said during his opening remarks. “The Democrats know it’s their fault.”
Democrats fought to extend the subsidies for three years, but the bill failed to pass the Republican-controlled Congress.
“Make no mistake,” said Rep. Frank Pallone, Jr., D-N.J., ranking member of the Energy and Commerce Committee, “congressional Republicans and President Donald Trump are responsible for the health care affordability crisis Americans are experiencing today. »
Last week, Trump announced his long-awaited health care plan. The plan, a hodgepodge of ideas already put forward by the president, has drawn criticism for its lack of detail.
