Health insurance CEOs point fingers over soaring health care costs

Some of the nation’s top health insurance executives sought to deflect blame for the soaring cost of health care in the U.S., arguing that rising hospital and prescription drug prices were driving premiums higher and making health care less affordable for Americans. The CEOs of five major health insurers testified before a House Energy and Commerce subcommittee on Thursday, the first in a series of back-to-back hearings focused on finding the root causes driving unaffordability in the health care system, including skyrocketing premiums. “The cost of health care insurance fundamentally reflects the cost of health care itself. It is more of an effect than a cause,” said Stephen Hemsley, the CEO of UnitedHealth Group, the nation’s largest health care provider. “If insurance costs are going up, even as we compete aggressively against other companies, it signals rising costs of health services and drugs and rising volumes of care activity.” The hearings come amid ongoing debate over ObamaCare subsidies meant to lower the cost of monthly premiums for tens of millions of low and middle-income Americans. The enhanced premium tax credits, first enacted during the COVID-19 pandemic and later expanded under the Biden administration, expired at the end of 2025 over the objection of Democrats, resulting in higher out-of-pocket costs and fewer Americans enrolling in coverage. The House passed legislation earlier this month to extend the expired subsidies for three years, but the Senate has so far refused to take it up. Ellen Allen, a West Virginia resident enrolled in an ACA Bronze-level Plan, told lawmakers her premium jumped 323 percent from last year to nearly $2,000 after losing the subsidies. She said she was forced to forgo vision and dental insurance because she could not afford it. Democrats have slammed Republicans for not supporting the subsidies, framing their opposition as a betrayal of working-class families. Republicans, meanwhile, have long argued the ACA is a failing program that limits consumer choice and stifles market competition. “When Democrats passed ObamaCare without Republican support, they sold the bill on the promises that premiums would fall, competition would rise, and if you liked your insurance plan, you can keep it,” subcommittee Chairman Morgan Griffith (R-Va.) said in opening remarks at the hearing. “Instead, ObamaCare has increased healthcare costs, warped incentives, federalized benefits, restricted plan design, and limited access to care.” Facing mounting pressure to address health care unaffordability, President Trump unveiled outlines of health policies last week that he wants Congress to consider, including a proposal to send money directly to Americans for health savings accounts (HSAs). Trump touted the idea as allowing people to “buy their own health care,” but Democrats noted during Thursday’s hearing that the current law generally prohibits individuals from using their HSAs to pay for regular premiums. Rep. Frank Pallone (D-N.J.), the ranking member on the committee, dismissed the idea as “completely out of touch.” “Would having access to a health savings account put a dent in your health care costs?” Pallone asked Allen, providing an example of the account being preloaded with “a couple thousand dollars.” “Frankly, that’s insulting,” Allen responded. “A $2,000 deposit into a health savings account for someone whose premium is $2,000 a month doesn’t go a very long way, so it wouldn’t be very helpful at all.” Different players in the health care industry, from insurers to hospitals to drug manufacturers, long pointed fingers at each other for the affordability crisis and higher overall spending. The U.S. spent approximately $5.3 trillion, or about $15,474 per person, on health care in 2024, according to the Centers for Medicare & Medicaid Services (CMS). Gail Boudreaux, president and CEO of Elevance Health, said the spending increase was spurred by higher costs for medical care and prescription drugs, which in turn directly impacted premiums. “When the prices charged for care rise, premiums and out-of-pocket costs rise too,” Boudreaux said. “When the same service is billed at a much higher price in a hospital setting than in a physician’s office or urgent care…fraud, improper billing, and administrative requirements also add costs that ultimately show up in premiums.” The executives said their companies were leveraging competition, especially in prescription drugs, as a way to drive costs lower for consumers. Lawmakers on both sides of the aisle pushed back on that narrative, arguing insurers had taken concrete steps to do the opposite by consolidating within the market. “There’s a real concern when a single corporation controls coverage, processing, dispensing, and care decisions,” Rep. Diana Harshbarger (R-Tenn.) said. “When that level of vertical integration exists, competition erodes, and patients end up paying more. That’s just the bottom line.” Rep. Alexandria Ocasio-Cortez (D-N.Y.) later emphasized that point by examining CVS’s corporate structure. An insurance company, a health clinic, pharmacies and a pharmacy benefit manager all fall under the CVS Health umbrella. “That’s quite a bit of market concentration, wouldn’t you agree?” Ocasio-Cortez asked CVS Health CEO David Joyner. “No, I wouldn’t agree that it’s market concentration. I would suggest it’s a model that works really well for the consumer,” Joyner replied. “Yeah, I think it works very well for CVS,” Ocasio-Cortez shot back. “The health insurance gets a cut, the pharmacy benefit manager gets a cut, the drug manufacturer gets a cut, and the patient gets screwed,” she continued. David Cordani, the CEO of Cigna, and Paul Markovich, the CEO of Asendiun, the nonprofit parent company of Blue Shield of California also appeared before committee.