Insurance CEO hearings: Takeaways from a long day on Capitol Hill

Modern Healthcare – Friday, January 23, 2026
By Noah Tong

Health insurance leaders defended their industry’s role in the healthcare system to lawmakers Thursday and largely deflected blame for high costs onto providers and drugmakers.

UnitedHealth Group CEO and Chair Stephen Hemsley, CVS Health President and CEO David Joyner, Elevance Health President and CEO Gail Boudreaux, Cigna CEO and Chair David Cordani, and Ascendiun President and CEO Paul Markovich sat for a pair of hearings before the House Energy and Commerce’s Health Subcommittee and the House Ways and Means Committee, which ran for almost 10 hours.

Members of Congress from both parties confronted the executives on rising costs, their salaries, prior authorizations, Medicare Advantage and vertical integration. Even so, the hearings were less than feisty most of the time considering the political stakes for Republicans and Democrats during an election year.

Still, lawmakers mainly adhered to partisan talking points and no consensus emerged about how to fix what’s wrong with the healthcare system, and the CEOs mainly offered subdued defenses of how their companies operate.

Here are three key themes that emerged from the hearings.

Republicans, Democrats play blame game

Members of the Republican majority frequently used the hearings as a platform to trash the Affordable Care Act of 2010.

“Obamacare has increased healthcare costs, warped incentives, federalized benefits, restricted plan design and limited access to care,” said Rep. Morgan Griffith (R-Va.), who chairs the Health Subcommittee.

Meanwhile, Democrats hammered away at the recent expiration of enhanced subsidies for health insurance exchange plans and the healthcare cuts included in President Donald Trump’s tax law.

“Our Republican friends have no interest in strengthening healthcare or protecting patients,” said Ways and Means Committee ranking member Richard Neal (D-Mass.). “They used their signature legislation to slash $1 trillion.”

The hearings also featured moments when traditional partisan views on health insurance companies appeared to reverse, as Republicans slammed the industry and some Democrats defended it.

“This is the Republicans’ fault. It’s not your fault,” Energy and Commerce Committee ranking member Frank Pallone (D-N.J.) said to the executives. “Don’t let them drag you in here and blame you for what’s going on,” he said.

“If I had my way, I’d turn all of you guys into dust,” said Rep. Dr. Greg Murphy (R-N.C.). “If it were up to me, I would throw out all for-profit systems in this country and turn everybody into nonprofit.”

Two Republicans sought the CEOs’ endorsements of Trump’s recently released healthcare framework, but they declined to extend any.

Bipartisan complaints

Insurance companies are easy targets for politicians. Many committee members readily took the opportunity, condemning prior authorizations, high out-of-pocket costs and lucrative executive compensation packages.

“How do you justify getting paid that much when so many of your patients struggle to afford skyrocketing premiums?” Rep. Buddy Carter (R-Ga.) said.

The insurance leaders repeatedly pointed toward other players in the healthcare system as the root causes of high costs.

“If insurance costs are going up even as we compete aggressively against other companies, it signals rising costs of health services and drugs and rising volumes of care,” Hemsley said.

Markovich, whose nonprofit company owns Blue Shield of California, called on Congress to do something about the shortcomings in the healthcare system.

“The system will not fix itself,” Markovich said. “The healthcare system needs some tough love and clarity, and I believe the American government is in the best position to provide both.”

Ahead of the hearing, several insurers highlighted initiatives meant to show a willingness to adapt.

CVS Health, for instance, announced its Aetna insurance subsidiary now approves 95% of prior authorizations within 24 hours and that requests are bundled more frequently.

Most notably, UnitedHealth Group agreed to return its profits from its exchange plans — a small fraction of its business — to members this year. When questioned, the CEOs of the other four insurers would not make the same pledge.

Consolidation under fire

The evolution of companies such as UnitedHealth Group, CVS Health and Cigna into vertically integrated conglomerates was a hot topic throughout the day. Republicans and Democrats alike decried the effects on competition while the CEOs insisted consolidation is critical to their businesses and the system at large.

Ties between these companies’ insurance, pharmacy benefit manager and group purchasing organization arms received a lot of scrutiny.

UnitedHealth Group owns the PBM OptumRx and the GPO Emisar Pharma Services; CVS Health owns the PBM CVS Caremark and the GPO Zinc Health Services; and Cigna owns the PBM Express Scripts and the GPO Ascent Health Services. Lawmakers emphasized that Emisar Pharma and Ascent are based overseas, which frees them from some U.S laws.

These quotes illustrate the widespread antipathy to healthcare consolidation on display at the hearing.

• Ways and Means Committee Chair Jason Smith (R-Mo.): “This level of control and consolidation is supposed to lead to greater efficiencies, lower premiums and lower deductibles. But that’s not what has occurred.”
• Rep. Lloyd Smucker (R-Pa.): “You would expect if a marketplace is working properly, that perhaps under consolidation we would see lower, or at least slower-growing, premiums in highly concentrated markets. But that’s just simply not happening.”
• Rep. Jake Auchincloss (D-Mass.): “These GPOs are an attempt to circumvent national authority over PBM reform.”
• Rep. Alexandria Ocasio-Cortez (D-N.Y.): “This is actually an interesting point of common ground that I may have with some of our
• Republican colleagues here in this hearing, because whether you’re a blue-blooded capitalist or a card-carrying democratic socialist, I think corporate monopolies are a problem, and this vertical integration is destroying people’s ability to access care.”
• Rep. Dr. Mariannette Miller-Meeks (R-Iowa): “Are PBM GPOs just a cover for the ‘Big Three’ to say in a contract that they pass through 100% of rebates they get and also a way to keep anyone else from being able to access brand drugs?”

Executives countered that consolidation leads to greater levels of efficiency. “We see the combination businesses that we’re in as helping solve and or address the challenges in healthcare,” Joyner said.

Near the end of the day, one point of agreement arose. Rep. Nathaniel Moran (R-Texas) asked the CEOs if the healthcare system is “broken.” Of the five executives, only Boudreaux hesitated to say yes.

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