Congress grills insurer CEOs over rising health care costs

Senior executives from several of the nation’s largest health insurers faced sustained scrutiny on Capitol Hill as lawmakers pressed them to explain steep increases in hospital and drug prices and the role of affiliated pharmacy benefit managers. Testimony on January 22, 2026, unfolded in a series of back-to-back hearings that focused on why health care is becoming less affordable for consumers.

Executives from UnitedHealth, Cigna, CVS Health, Elevance Health and Blue Cross Blue Shield of California appeared before multiple congressional panels. Lawmakers repeatedly directed attention to hospital spending, prescription drug prices and the business ties between insurers and the so-called Big Three PBMs. UnitedHealth owns Optum Rx, Cigna operates Express Scripts and CVS runs Caremark, a combination that has drawn particular interest from legislators concerned about vertical integration and market concentration.

Gail Boudreaux of Elevance Health told lawmakers that hospital spending increased by 9% in 2024, a jump she framed as a major driver of rising premiums and out-of-pocket costs. Stephen Hemsley of UnitedHealth emphasized the long arc of hospital price growth, saying hospital prices have risen “three times faster than inflation in the last 25 years” and noting that hospital services now account for more than 30% of overall health-care spending. Those figures were central to lawmakers’ arguments that unchecked hospital pricing and consolidation are shifting costs to patients and employers.

Prescription-drug pricing drew blunt exchanges as well. David Cordani of Cigna highlighted the escalating cost of new therapies, stating that “the median price of a new prescription drug was $370,000 in 2024,” and contrasted that with a figure of “about $2,000 less than 20 years ago.” Lawmakers used that testimony to press insurers on how drug prices are negotiated, the passage-through of manufacturer costs to plans and patients, and whether current industry practices contain sufficient incentives to lower prices.

Several members of Congress said they were particularly troubled by the presence of PBMs within large insurance companies. Lawmakers sought details on how PBMs set formularies, negotiate rebates and steer patients toward in-network pharmacies, and whether those practices favor insurers’ own PBM units at the expense of competitors and consumers. Executives fielded aggressive questioning about conflicts of interest and whether existing disclosures and firewalls are adequate to prevent self-dealing.

The hearings reflected a coordinated oversight effort by lawmakers from both parties, who pointed to rising premiums, higher deductibles and growing out-of-pocket burdens as evidence that market forces have failed many Americans. The sessions did not produce immediate policy commitments or new legislation, and coverage of the day did not provide complete roll calls for every panel or verbatim transcripts of the exchanges.

Industry leaders defended their companies by pointing to the complexity of the health-care system and the role of multiple actors, including hospitals and drug manufacturers, in setting prices. But lawmakers signaled that further investigation, subpoenas or legislative fixes could follow if answers and transparency proved insufficient. For consumers and employers already feeling squeezed, the hearings underscored that oversight of payers, providers and PBMs will remain a focal point of health policy debates this year.