The CEOs of five major health insurers are set to face a grilling from members of Congress on Thursday as House Republicans seek to place blame for rising health care costs.
The back-to-back hearings before the Energy and Commerce and the Ways and Means committees come after Republicans allowed enhanced Affordable Care Act subsidies to expire at the end of last year, a move that led to sharp premium increases for millions of Americans.
Congress has few immediate plans to address the lapse in the tax credits. The House and the Senate have yet to reach a deal to lower skyrocketing health insurance premiums. And with the Senate out this week and the House set to go into recess next week, the odds of passing a bill anytime soon are very slim, experts say.
“Insurance companies are an easy target because they make people miserable through prior authorization review and in many other ways,” said Drew Altman, president and CEO of KFF, a nonpartisan health policy research group.
The CEOs of UnitedHealth Group, CVS Health Group, Cigna Health Group, Elevance Health and Ascendiun are set to testify.
President Donald Trump and Republicans are facing criticism from voters about the cost of living, including health care.
Last week, Trump rolled out his long-awaited health care plan, which included a proposal to redirect funding used for ACA subsidies into health savings accounts. The plan offered few details and drew criticism for largely restating ideas Trump has previously floated. Many of the proposals need congressional approval, raising questions about how quickly — or whether — they can be implemented.
Trump’s plan is not expected to be the focus of Thursday’s hearings.
Instead, they are expected to be the first in a series to examine the “root causes” driving higher health care prices, committee Chairs Brett Guthrie, R-Ky., and Jason Smith, R-Mo., said in a statement.
Thursday’s hearings will also take aim at the ACA, which Republicans say is a major driver of higher health care costs.
“The ACA mandated coverage for individuals regardless of underlying health conditions and largely prohibited plans from underwriting plans at the individual level,” a hearing document says, “effectively increasing health care access and affordability for the unhealthiest Americans but also driving up health care costs for healthier Americans.”
Gideon Lukens, a senior fellow and director of research and data analysis on the health policy team at the Center on Budget and Policy Priorities, a nonpartisan research group, said the ACA fixed the issues around coverage for people with pre-existing conditions and made the overall insurance market “functional and stable.”
“Before the ACA, insurers on the individual and small-group markets could deny coverage to people with pre-existing conditions like cancer or diabetes, or could charge them much more,” he said. “Insurance premiums in these markets often fluctuated widely year to year, and options were limited.”
The “elephant in the room,” he added, is the expired enhanced ACA tax credit.
“A hearing on health care affordability should focus on the affordability crisis that’s unfolding right now because of the choice to allow the enhancements to expire,” Lukens said. “A lot of harm can still be prevented, but an extension is needed as soon as possible.”
Insurers have long argued that premium hikes largely reflect rising costs elsewhere in the health care system, particularly rising hospital and prescription drug costs.
Premiums rose this year not only for ACA plans, but also for job-based insurance and Medicare.
According to written testimony, Stephen Hemsley, the CEO of UnitedHealth Group, the nation’s largest health insurer, plans to tell lawmakers that insurers “compete aggressively” to keep premiums at prices people can afford, but the cost is largely determined by the broader health care system.
“It is a symptom, not a cause,” Hemsley’s testimony reads. “Premium rates are based on two key factors: how much care is used and how much is charged for that care. When the price of care goes up and care activity increases, the cost of health coverage necessarily follows.”
David Joyner, CEO of CVS Health, said the company helps families “struggling with an often confusing, disconnected system and the rising cost of health care.”
“What’s driving these costs is understood: Greater demand for care, growing medical provider costs, and persistently high prices for hospital care and prescription drugs,” he wrote.
