Commercial health insurer CEOs testify on health care affordability; AHA submits statements for House hearings
The House Energy and Commerce Subcommittee on Health and Ways and Means Committee Jan. 22 hosted hearings on health care affordability that included testimony from leaders of five major commercial health insurers: Stephen Hemsley, CEO of UnitedHealth Group, David Joyner, chairman and CEO of CVS Health, Gail Boudreaux, president and CEO of Elevance Health, David Cordani, president, CEO and chairman of the board of The Cigna Group, and Paul Markovich, president and CEO of Ascendiun. Both hearings focused on rising health care costs and access challenges under commercial coverage. The AHA shared statements with both committees that discussed the current landscape of affordability and how the insurance market has driven health care costs upward.
“We share the committee’s concerns regarding the cost of health care and coverage, and we appreciate your focus on the role insurers play in high and rising costs for American families, taxpayers and employers,” the AHA wrote. “For years, the AHA has highlighted how, even when patients have insurance, their access to care is being delayed, disrupted and denied. Simply put, actions by many commercial insurers erect barriers that make it more difficult for patients to receive timely access to needed medical care.
“To understand what is happening to health care affordability, it is first necessary to understand how dramatically the health insurance market has changed. Today, the seven largest commercial insurers account for over 190 million covered lives — roughly two-thirds of the entire insured population — across various forms of coverage, including Medicare Advantage (MA), employer-sponsored care, Medicaid managed care, and health insurance marketplace plans. Although their stated role is to help patients access care, in reality, they are often described as a frustrating middleman, creating needless obstacles and barriers that delay or prevent patients from seeking the health care they need and deserve.”
Among other topics, the AHA highlighted how horizonal and vertical integration increased profits for insurers while increasing health care costs, and how insurers' excessive use of prior authorization to delay and deny coverage harms patients and providers. The AHA also made a series of recommendations to Congress to improve health care affordability, including prior authorization reform, creating prompt payment standards for MA plans and increasing network adequacy standards, especially in post-acute care.