Health Insurance CEOs Questioned by House Committee About Rising Costs in Health Care

Health care affordability has been a top priority of the second Trump administration, spurred by headlines and surveys showing patients’ cost concerns. With premiums for the Affordable Care Act (ACA) increasing this past month due to the expiration of subsidies,¹ addressing these health care costs has become even more pressing. The House Committee on Energy and Commerce invited CEOs of health companies to discuss why health costs are rising and ways of addressing these skyrocketing costs.²

The health hearing in the House Committee on Energy and Commerce started with statements from both Democratic and Republican representatives. Rep Morgan Griffith (R, Virginia) introduced the committee by stating that the ACA was not living up to the promises made in 2010 when the bill was passed, as costs for health care have skyrocketed and citizens have few options for health care, rather than the competition that was originally promised, noting that “in some states, a single insurer may even control 80% or 90% of the market.”

“Competition is essential for patient access; lack of competition and consolidation within the insurance marketplace has led us to higher health care costs as a whole,” he concluded.

Rep Diana DeGette (D, Colorado) pointed to the low number of uninsured people in the country now that the ACA is available and blamed Republicans for not extending the ACA subsidies last year and earlier this month in the House bill.³ DeGette called on Senate Republicans to join House Democrats to extend the ACA subsidies, saying, “To do anything else is to accept a poorer and sicker America.”

Stephen Hemsley, CEO of UnitedHealthGroup; David Joyner, president and CEO of CVS Health; Gail Boudreaux, MBA, president and CEO of Elevance Health; David Cordani, MBA, president, CEO, and chairman of the board at The Cigna Group; and Paul Markovich, MA, president and CEO of Ascendiun, were all in attendance for the hearing. Their opening statements all reiterated their desire to work with Congress to lower health care costs for patients across the country. A witness, Ellen Allen, was also in attendance to speak on the importance of the ACA for her in particular, as she faced increased premiums this January.

Griffith questioned the CEOs on whether more competition should be introduced in the insurance space, noting that in his district there is only 1 provider, which could affect the ability of insurers to negotiate prices with health systems in the area, with Cordani noting that more choice usually leads to more affordability, and fewer choices mean price inflation.

Rep Brett Guthrie (R, Kentucky) confirmed with Boudreaux that health care premiums would have still increased in 2026 regardless of the ACA subsidies being extended due to “underlying root causes.”

Guthrie posited that the medical loss ratio (MLR) policy of the ACA incentivized insurance plans to have higher premiums because insurers are penalized for trying to curtail health costs. Joyner responded, saying that CVS Health did not perform well in the exchange last year and costs exceeded the premiums collected, regardless of the MLR, which led to CVS Health giving back money to the government. Boudreaux and Cordani also confirmed that their companies did not make profits the last several years. Guthrie also questioned Hemsley on vertical integration when it comes to encouraging competition; Hemsley stated that vertical integration is easier on patients when they are getting care.

Rep Diana Harshbarger (R, Tennessee) also brought up vertical integration through her own experience as a pharmacist. The same corporate family, she said, decides what’s covered, sets drug prices through pharmacy benefit managers, controls the pharmacy counter, owns the doctors, and makes referrals. “That is not competition; that is control,” she said.

Hemsley reiterated that the goal is to provide “a better value and a better experience to the consumer.” Joyner agreed that “putting these businesses together, [they] believe [they’re] solving, for one, the fragmentation.”

DeGette confirmed with Cordani that the ACA requires that those with preexisting conditions cannot be denied health insurance. Rep Frank Pallone (D, New Jersey) questioned Allen on President Donald J. Trump’s new health care plan, which calls on giving patients money to put into health savings accounts, and whether it would be helpful to her, which she denied. Pallone stated that he believes the plan will favor the wealthy, as they have excess money to put into health savings accounts.

Rep Raul Ruiz (D, California) also questioned the CEOs on where patients seek care when they are uninsured, with Markovich confirming that many will go to the emergency department, which is a high-cost setting of care and drives up premiums. Ruiz noted the passage of the One Big Beautiful Bill “that cuts Medicaid up to $1 trillion. It’s going to leave 15 million people uninsured… But we’ve argued all along that doing that will raise costs for everybody.”

Overall, both sides of the aisle emphasized the rise in health care costs, with Republicans concerned about the lack of competition and Democrats concerned about how an increase in uninsured patients would affect health care costs for all. Just 2 weeks after the House passed an extension of the ACA subsidies, Senate action will be required to enact change, though it remains uncertain whether both of these aspects of care will be addressed.

References

1. McCrear S. Expiring ACA subsidies and CMS payment models raise costs for consumers and employers. AJMC^®. November 25, 2025. Accessed January 22, 2026. https://www.ajmc.com/view/expiring-aca-subsidies-and-cms-payment-models-raise-costs-for-consumers-and-employers
2. Ways and Means, Energy and Commerce Committee leaders release details for health insurance company hearings on affordability. News release. Ways & Means. January 8, 2026. Accessed January 22, 2026. https://waysandmeans.house.gov/2026/01/08/ways-and-means-energy-and-commerce-committee-leaders-release-details-for-health-insurance-company-hearings-on-affordability/
3. Bonavitacola J. House votes to extend ACA subsidies, eyes turn to Senate. AJMC. January 8, 2026. Accessed January 22, 2026. https://www.ajmc.com/view/house-votes-to-extend-aca-subsidies-eyes-turn-to-senate