Well being insurer CEOs confronted questions Thursday about well being care prices, vertical integration and prior authorization from the Home Power and Commerce Committee and the Home Methods and Means Committee.

The insurer’s witnesses included Stephen Hemsley, CEO of UnitedHealth Group; David Joyner, president and CEO of CVS Well being; Gail Boudreaux, president and CEO of Elevance Well being; David Cordani, president, CEO and chairman of the board of administrators of The Cigna Group; and Paul Markovich, president and CEO of Ascendiun (guardian firm of Blue Defend of California).

Ellen Allen, government director of West Virginians for Inexpensive Healthcare, additionally testified earlier than the Power and Commerce Committee, whereas ReShonda Younger, an Iowa resident and small enterprise proprietor, testified earlier than the Methods and Means Committee.

Listed below are 4 key takeaways from the hearings:

1. Everybody agrees that healthcare affordability is an issue: Throughout each hearings, lawmakers emphasised that well being care has turn out to be too costly and that People are combating rising premiums, deductibles and out-of-pocket prices.

Rep. For instance, Power and Commerce Committee Chairman Morgan Griffith (R-Virginia) argued {that a} “lack of competitors and consolidation inside the insurance coverage market has led us to greater well being care prices as a complete.” Rating Member Rep. Diana DeGette (D-Colorado) said that “People know that well being care is much too costly as a result of it takes up a bigger share of our financial system than another developed nation.”

Well being insurer CEOs agreed that well being care prices are a serious drawback.

“Our well being care system is broke and failing us,” Markovich mentioned in his opening assertion. “It is too costly, it is too impersonal. It does not cowl everybody. It scores worse on high quality than in different international locations, and it is distrusted by far too many People. That is unacceptable.”

2. Everybody has completely different concepts to sort out the affordability drawback: Whereas there may be broad settlement that healthcare is simply too costly, consensus on repair it’s rapidly disintegrating. Republicans largely blamed an absence of competitors, consolidation and the construction of the Inexpensive Care Act for healthcare prices. Democrats pointed to the necessity to prolong the ACA premium tax credit, which expire on the finish of 2025.

This divide was illustrated throughout the opening statements of the Method and Means Committee listening to. Chairman Rep. Jason Smith (R-Missouri) criticized Democrats for failing to deal with affordability and accused them of defending insurance coverage corporations and enabling market consolidation.

“After 15 years of a Democrat-created well being care system underneath Obamacare, costs have solely gone up, not down,” he mentioned. “They’ve solely gone up. I additionally need to remind my Democratic colleagues that these identical corporations have exploited market energy and vulnerabilities in federal packages to consolidate management, direct affected person care and maximize income.”

Rating Rep. Richard Neal (D-Massachussetts) turned the blame again on Republicans for permitting the ACA tax credit to run out.

“Our Republican associates have no real interest in strengthening well being care or defending sufferers. … They’ve refused to increase the tax breaks now we have requested for many times, forcing thousands and thousands to surrender their well being care this yr, and have remained silent because the Trump administration wages an all-out struggle on public well being and, sure, science,” Neal mentioned.

Insurers, in the meantime, largely blamed hospitals and pharmaceutical corporations for rising prices.

“The price of medical insurance essentially displays the price of well being care itself,” Hemsley mentioned. “It is extra of a consequence than a trigger. When insurance coverage prices rise, at the same time as we compete aggressively with different corporations, it indicators rising prices of well being care, medicine, and rising volumes of well being care operations. And the very fact is that spending on hospitals and medicines has grown at thrice the speed of inflation since earlier than 2000.”

3. Vertical integration: Insurers confronted many questions from each side of the method about their vertical integration with PBMs, pharmacies and clinics. Throughout the Method and Means Committee listening to, Rep. Greg Murphy (R-North Carolina) said that vertical integration “has destroyed competitors on this nation.”

“I do not usually agree with Mark Cuban, however we do agree that what must occur is you guys want to interrupt up. … If it had been as much as me, I would flip you all into mud. We would begin once more. We would have competitors,” he mentioned.

Rep. Alexandria Ocasio-Cortez (D-New York) centered her questions on CVS Well being, noting that the corporate owns insurer Aetna, PBM CVS Caremark and medical clinics Oak Avenue Well being. She requested Joyner if he agreed that that is “fairly a little bit of market focus,” to which he replied that he disagreed and that it’s a “mannequin that works very nicely for shoppers.”

4. Prior consent and refusals: Insurers had been additionally surveyed about their prior licensing practices and the variety of purposes denied. A key second occurred throughout the Power and Commerce Committee listening to, through which Rep. Buddy Carter (R-Georgia), who practiced pharmacy, requested Hemsley if he ever seemed a affected person within the eye and defined why UnitedHealthcare denied their treatment.

Hemsley responded that he has usually seemed sufferers within the eye, however cannot bear in mind whether or not it was prior consent.

“I am the one who needed to look the affected person within the eye,” Carter argued. “I am the one who needed to inform them in your behalf that it is not enjoyable.” He then advised a narrative a couple of single mom in Kentucky who was recognized with most cancers and denied her treatment by UnitedHealthcare.

Picture: Valerii Evlakhov, Getty Photographs