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Congressional hearings this week brought the chief executives of the nation’s largest health insurance companies before lawmakers to address soaring costs and rising profits, even as families struggle to afford coverage. The hearings, which included testimony from leaders at UnitedHealth Group, CVS Health, Elevance Health, Cigna, and Ascendiun, come amid growing scrutiny of the industry’s financial performance and its role in the American healthcare system.
The sessions on Capitol Hill, held January 22, 2026, revealed a stark contrast between the insurers’ explanations for rising costs and the concerns voiced by members of Congress. Insurers largely attempted to deflect blame, pointing to hospitals, pharmaceutical companies, and the expense of new weight loss drugs, a strategy that, according to reports, has been largely unsuccessful.
The hearings follow a period of significant financial gains for major insurers. Collectively, seven of the largest insurers amassed $34.1 billion in net profit in 2024, with profits continuing to climb at a rapid pace. UnitedHealth Group, for example, saw its annual revenue increase by nearly 1,800% – to $379 billion – between 2000 and 2024, although its net profit increased by 1,860% to $14 billion.
The dynamic between Democrats and the insurance industry has shifted significantly in recent decades. What was once a relationship characterized by opposition has evolved into a partnership, with some critics arguing that this alliance is driving up healthcare costs. Representative Frank Pallone (D-NJ), the ranking member on the House Energy and Commerce Committee, publicly stated that rising healthcare costs were “not your fault,” a sentiment that has drawn criticism from those seeking greater accountability from the industry.
Concerns were also raised regarding the role of taxpayer dollars in propping up the insurance industry. A six-week government shutdown last fall was partially attributed to Democratic demands for additional funding for insurers through programs like the Affordable Care Act (ACA) and Medicare. UnitedHealth Group has also benefited from substantial payments related to its licensing of the AARP brand, receiving $9 billion in royalties in 2024 alone.
One area of particular concern is Medicare Advantage, a program intended to increase access to care for seniors. However, the program is now estimated to cost taxpayers an additional $84 billion annually due to overpayments to insurers. Critics point to issues such as lengthy prior authorization processes, which can delay necessary care, and upcoding – the practice of insurers adding unnecessary diagnoses to justify higher payments. SSM Health and UnitedHealthcare recently reached a multiyear agreement to maintain network access for patients, following a temporary contract signed in December.
The ACA’s Medical Loss Ratio regulation, which requires insurers to spend 80 to 85% of premiums on claims, also incentivizes insurers to inflate claims rather than focus on cost efficiencies. This creates a system where insurers are rewarded for paying out more in claims, potentially leading to inflated prices and unnecessary procedures.
The hearings took place as the industry faces increasing pressure to address affordability and access issues. UnitedHealth Group announced plans to return ACA profits to its marketplace members in 2026, but the long-term impact of this move remains to be seen. The future of healthcare affordability and access remains uncertain as Congress and the administration grapple with the complex challenges facing the American healthcare system.
