Lawmakers in Washington, D.C., confronted health insurance CEOs on March 14, 2024, during a series of back-to-back hearings in the House of Representatives. Executives from major insurers, including UnitedHealth Group, CVS Health Group, Cigna Health Group, Elevance Health, and Ascendiun, faced intense scrutiny over rising health care premiums, stringent prior authorization rules, and the denial of claims affecting millions of Americans.
The hearings, organized by the House Energy and Commerce Committee and the Ways and Means Committee, highlighted the growing discontent among consumers as health insurance premiums have soared. For individuals enrolled in the Affordable Care Act, the expiration of enhanced subsidies at the end of 2025 has led to premiums doubling or tripling in some instances. Meanwhile, those with employer-based insurance have also seen significant increases, which insurers attribute to the surging costs of prescription drugs and hospital care.
During the hearings, Rep. Debbie Dingell, a Democrat from Michigan, expressed frustration over the situation. “Millions of Americans across the nation have seen their health care premiums skyrocket,” she stated. “Yet, all of you are posting record profits.”
In a similar vein, Rep. Jodey Arrington, a Republican from Texas, emphasized the economic strain on families, stating, “It’s crushing over families, it’s a drag on our economy and it’s a threat to my children’s future.”
The insurance executives defended their positions, arguing that rising premiums are reflective of escalating costs throughout the health care system. David Cordani, CEO of Cigna, asserted, “We work every day to lower the cost of health care,” emphasizing that the industry remains competitive in pricing.
Concerns Over Market Concentration
Throughout the hearings, lawmakers scrutinized the growing influence of pharmacy benefits managers (PBMs) that are owned by these insurance giants. Rep. Alexandria Ocasio-Cortez of New York questioned David Joyner, CEO of CVS Health, regarding the concentration of market power, noting that CVS manages approximately 30% of all prescriptions filled in the U.S. Ocasio-Cortez stated, “Mr. Joyner, that is quite a bit of market concentration,” to which Joyner replied, “It’s a model that works really well for the consumer.”
Moreover, Rep. Buddy Carter of Georgia challenged Joyner about his reported compensation of $41 million in 2024, questioning the justification behind such a high salary.
The hearings also highlighted individual cases where patients faced denial of coverage. Rep. Kim Schrier, a Democrat from Washington, recounted a constituent who was denied hospitalization by UnitedHealth Group following a stroke. “That is just unconscionable and shameful,” she told Stephen Hemsley, CEO of UnitedHealth Group, adding that such experiences contribute to public dissatisfaction with insurance companies.
Bipartisan Criticism and Future Hearings
These hearings represent the beginning of a broader investigation into the underlying causes of high health care costs. While both Republicans and Democrats expressed criticism towards the insurance companies, they also directed blame at each other regarding the health care crisis. Rep. Jason Smith, Republican chairman of the Ways and Means Committee, argued that the Affordable Care Act has led to escalating prices, stating, “Obamacare prices have only gone up, not down.”
Conversely, Democrats accused their Republican counterparts of using the hearings as a distraction from their own inaction regarding rising premiums. Rep. Frank Pallone Jr., the ranking member of the Energy and Commerce Committee, asserted, “Make no mistake, congressional Republicans and President Donald Trump are to blame for the healthcare affordability crisis Americans are experiencing today.”
As the hearings concluded, the focus is expected to shift towards finding solutions to the health care affordability crisis, with ongoing discussions on extending subsidies to alleviate the financial burden on American families. Last week, Trump unveiled a new health care plan that has drawn criticism for lacking specific proposals, further complicating the dialogue surrounding health care reform.
The unfolding drama in Congress reflects a critical moment in health policy, with lawmakers under pressure to address the escalating costs impacting millions of Americans.
