HEALTH SUBCOMMITTEE HOLDS HEALTH INSURANCE COMPANY CEOS ACCOUNTABLE FOR SKYROCKETING COSTS

The following information was released by the U.S. House of Representatives Committee on Energy and Commerce, Republicans :

Today, Congressman Morgan Griffith (VA-09), Chairman of the Subcommittee on Health, led a hearing titled Lowering Health Care Costs for All Americans: An Examination of Health Insurance Affordability, featuring witness testimony from the biggest health insurance plan CEOs in the United States. During the hearing, Committee Republicans held health insurance plans accountable in their role of increasing health care affordability challenges impacting all Americans and discuss how Democrat policy failures in Washington D.C. have warped the American health care system and hurt patients access to high-quality health coverage options.

"Many patients have fewer plan choices than they did before Obamacare was enacted. Therefore, Obamacare coverage is not translating to patient or taxpayer affordability," said Chairman Griffith. "We owe it to patients to have a health system that offers real choices, transparent prices, and coverage that fits their needs, and I look forward to seeing how today's conversation presents solutions to make health care more affordable for all Americans."

Below are key excerpts from today's hearing:

Congressman Brett Guthrie (KY-02): "Experts, including the Congressional Budget Office, estimated that the expiration of the temporary Obamacare enhanced COVID Credit is projected to increase premiums by anywhere from 4 percent and 8 percent, depending on the market. Yet, many areas for 2026, insurers requested and were approved for premium increases of 30 percent, 40 percent, even 50 percent. So, Mrs. Boudreaux, you're in Kentucky. The average Elevance Obamacare plan increased its premium by roughly 24 percent. Despite what Democrats would have the American people believe, the temporary COVID Credit does little to actually lower underlying Obamacare premiums and the American taxpayers are footing the bill. So, Mrs. Boudreaux, by your best estimationeven if the Democrats' temporary COVID Credits were extendedwould Obamacare plan bids in my state of Kentucky increase or decrease between 2026 and 2025?" Mrs. Boudreaux: "Well, thank you very much for the question, Congressman. You know, as we've shared, premiums reflect the underlying costs..." Chairman Guthrie: "So, they would have increased, right?"

Congressman John Joyce, M.D. (PA-13): "Since the passage of the ACA, we have seen costs across all markets continue to increase. One of the key issues driving this is the medical loss ratio, or the MLR, that requires plans to spend either 80 percent or 85 percent of your premium dollars on health care expenses. The MLR created multiple perverse incentives for insurance companies to dramatically consolidate both vertically and horizontally. The companies that you lead today are not just involved in insurance. You own PBMs, you own specialty pharmacies, you own retail pharmacies, you own GPOs, you own physician groups and practices. In some cases, you own hospitals, and you own drug manufacturing companies. And at least one of you owns a bank! This has led to alleged cases of self-dealing, as your companies work to circumvent the [multi-level marketing] requirements."

Congresswoman Mariannette Miller-Meeks (IA-01): "The largest PBMsCVS Caremark, Express Scripts, and Optumhave created rebate contracting entities, or PBM group purchasing organizations, which are adding to the complex and opaque nature of the medicine supply chain. My first PBM reform bill on transparency was in 2019, as an Iowa state senator. PBMs claim these entities provide them and their clients with greater bargaining power to lower costs, but recent investigations by Members of Congress, industry experts, state attorneys general, and federal oversight agencies suggest the opposite may be true. We have a graph up here. Let's start with the left. The drugmaker pays rebates directly to the PBMs and PBM GPOs to ensure their drugs are included on their health plan formulariesmeaning the drugs are covered by insurance. Then, these PBMs and their PBM GPO subsidiaries collect the rebates, which they promise to pass through to their patients and health plans. Can any of you tell me what percentage of rebates are passed through to the patient, who is paying a higher drug cost because the rebates are added to the price of the drug?" Top Health Insurers: "..." Congresswoman Miller-Meeks: "Is it zero?" Top Health Insurers: "..." Congresswoman Miller-Meeks: "You don't even know that you're not giving these patients back a rebate for paying higher drug prices."