Congress Grills Hospital CEOs on Rising Health Care Costs

Lawmakers and hospital executives clashed over whether recent and proposed federal policies are driving a national health care affordability crisis during a House Ways and Means Committee hearing with health system CEOs to examine the role these institutions play in the rising cost of health care for patients and their families.

The hearing reflects growing congressional attention to affordability across the entire health care supply chain, following a similar January 2026 hearing that put health insurance executives in the hot seat.

At the heart of the scrutiny are the sheer scale of hospital spending and 2 concerns: anticompetitive consolidation among hospital systems and opaque billing practices that critics say inflate costs without improving care.

“The entire health care system—hospitals, insurance companies, drug manufacturers, pharmacy middlemen—all bear responsibility for the high-cost patients face,” House Committee on Ways and Means Chairman Jason Smith (R, Missouri) said during his opening statement. He denounced the “corporatization of American hospitals” that has led to consolidation and the loss of local hospitals and physicians.

Witnesses included Sam N. Hazen, CEO of HCA Healthcare; Wright Lassiter III, president and CEO of CommonSpirit Health; Brian G. Donley, MD, president and CEO of New York-Presbyterian; and Michael Waldrum, MD, MSc, MBA, CEO of ECU Health, representing a mix of for-profit and nonprofit systems. They were joined by Brad Woodhouse, president of Protect Our Care, a health care advocacy organization created to lobby for the Affordable Care Act.

How Much Do Hospitals Contribute to Rising Health Care Spending?

KFF has reported that hospital spending accounted for 40% of the total growth in national health spending, representing a far larger share than any other health spending category.¹ Between 1998 and 2023, there were roughly 2000 hospital and health system mergers, according to other research from KFF.² Furthermore, RAND published research in 2022 indicating that horizontal consolidation leads to higher prices for providers, which in turn increases health spending, with some evidence that the same trend happens with vertical consolidation of hospitals and physician practices.³

“Simply put, hospitals are charging an insane amount for care,” Smith said.

The hospital industry has pushed back on that framing. In a statement to the committee during the January insurance CEO hearing, the American Hospital Association argued that hospitals' share of national health spending has remained relatively stable and that recent spending growth is driven largely by increased use and intensity of services rather than price increases alone, as well as pointing to insurance practices.

The Blame Game Between Hospitals and Insurers

During the hearing, Hazen noted that health care has never been better and more advanced, but it has also never been so expensive for patients. One of the most effective ways to address the challenge of affordable care is stable and reliable insurance coverage, he said.

“When patients have reliable coverage, they have greater access and can seek care earlier, manage chronic conditions more effectively, and avoid costly emergency interventions,” he said.

Hazen also spent time on the administrative complexity providers face due to insurance barriers, such as prior authorization and payment disputes due to denials and underpayment.

Expecting attacks aimed at insurers during the hearing, AHIP, the advocacy and trade association for health insurance companies, released a statement ahead of the hearing.

“Hospital costs account for more than 40 cents of every premium dollar—more than any other category—and many hospital systems continue to raise their prices at rates that dwarf inflation while also sticking patients with high bills with layers of opaque fees,” said Chris Bond, AHIP spokesperson. “Instead of blaming others, the hospital industry should stop their anticompetitive consolidation, opaque billing practices, and unaffordable price hikes that continue to drive Americans’ premium costs higher.”

Lassiter pointed specifically to Medicare Advantage (MA) plans: billing for MA patients is approximately 25% more expensive than traditional Medicare, and his system has $4.3 billion in unpaid Medicare Advantage claims. He called for “adequate reimbursement for Medicare and Medicaid.”

Federal Health Care Policy Changes

The impact of the One Big Beautiful Bill Act was raised multiple times throughout the discussion. Democrats and their invited witness, Woodhouse, repeatedly criticized the act for enacting “the largest cuts to health care in American history,” as Woodhouse said. Waldrun noted that his system is expecting $30 million in annual reimbursement losses, compounding over the next 10 years to a billion dollars in cuts to his rural delivery system.

One bipartisan area of agreement was the topic of site neutrality, and the Obama, Biden, and Trump administrations have all endorsed some form of site-neutral payment. “But every time we try to advance these so-called site-neutral policies, big hospitals, they fight us. They fight us tooth and nail,” Smith said.

When one representative asked the CEOs to raise their hands if they thought it was a good idea to have site neutrality, not a single one did so.

“This is one of the problems with health care hospitals,” Smith said. “They blame insurers and drug companies. Democrats blame Republicans. Republicans blame Democrats. Insurers blame hospitals and drug companies. Drug companies blame PBMs [pharmacy benefit managers] and hospitals. But when it comes to fixing the system, the only thing you all agree on, really, is that it's some other people, other issues, that's [causing] the increase [in costs].”

References

1. Godwin J, Levinson Z, Neuman T. Hospital spending accounted for 40% of the growth in national health spending between 2022 and 2024. KFF. February 11, 2026. Accessed April 28, 2026. https://www.kff.org/health-costs/hospital-spending-accounted-for-40-of-the-growth-in-national-health-spending-between-2022-and-2024/

2. Levinson Z, Godwin J, Hulver S, Neuman T. Ten things to know about consolidation in health care provider markets. KFF. April 19, 2024. Accessed April 28, 2026. https://www.kff.org/health-costs/ten-things-to-know-about-consolidation-in-health-care-provider-markets/

3. Liu JL, Levinson ZM, Zhou A, Zhao X, Nguyen P, Qureshi N. Environmental scan on consolidation trends and impacts in health care markets. RAND. September 30, 2022. Accessed April 28, 2026. https://www.rand.org/pubs/research_reports/RRA1820-1.html