Health

WASHINGTON, D.C.– Congressman Morgan Griffith (VA-09), Chairman of the Subcommittee on Health, delivered the following opening statement at today’s hearing titled Lowering Health Care Costs for All Americans: An Examination of Health Insurance Affordability.

Subcommittee Chairman Griffith’s opening statement as prepared for delivery:

“Today we will discuss health care costs and patient access challenges by examining affordability across the entire health insurance marketplace.

“This hearing builds on work Republicans have done this Congress to address health care affordability.

“We plan to have future hearings with other leaders and experts across the health care continuum to understand the root causes of rising health care costs.

“Specifically, this hearing will focus on the role insurers play in the delivery of care.

“The insurance market is dominated by a handful of Fortune 50 corporations that control the majority of the national market.

“In some states, a single insurer may even control 80 or 90 percent of a particular market.

“The biggest health insurers today often manage several facets of the health care supply chain, such as owning the pharmacy benefit managers; the group purchasing organizations; multiple provider groups; and specialty or mail-order pharmacies.

“Even with owning those, complicated benefit designs, narrow networks, prior authorization requirements, and opaque coverage decisions often leave patients feeling like they are paying more for less.

“The market also lacks transparency and is not easily navigable.

“One contributor to health insurance unaffordability for millions of Americans is the so called ‘Affordable Care Act,’ also known as Obamacare, that was signed into law in 2010.

“When Democrats passed Obamacare, without Republican support, they sold the bill on the promises that premiums would fall, competition would rise, and ‘if you like your insurance plan, you will keep it.’

“Instead, Obamacare has increased health care costs, warped incentives, federalized benefits, restricted plan design, and limited access to care.

“Many patients have fewer plan choices than they did before Obamacare was enacted. In fact, a constituent told me recently that his family only has one provider option. Therefore, Obamacare coverage is not translating to patient or taxpayer affordability.

“Unfortunately, employer-sponsored insurance is also becoming unaffordable, and, each year, more American small businesses choose not to offer health insurance because it is too costly.

“This impacts the ability for a small business to be competitive and attract talent.

“We know two things are true:

“Competition is essential for patient access! Lack of competition and consolidation within the insurance marketplace has led us to higher health care costs as a whole.

“The health care system needs to work for patients.

“That means empowering individuals with real choices, transparent prices, and coverage that fits their needs.

“We must strive to have more competitive plan options that reward quality and focus on affordability, access, and outcomes.

“Our discussion today is meant to move beyond politics and spur debate about how we can work toward delivering meaningful, innovative solutions for the Americans that we serve.

“We owe it to patients to get to the root causes of the challenges we see across the health sector, and I look forward to hearing from our witnesses.”

WASHINGTON, D.C. – Today, Congressman Morgan Griffith (VA-09), Chairman of the Subcommittee on Health, led a hearing titled Lowering Health Care Costs for All Americans: An Examination of Health Insurance Affordability, featuring witness testimony from the biggest health insurance plan CEOs in the United States. During the hearing, Committee Republicans held health insurance plans accountable in their role of increasing health care affordability challenges impacting all Americans and discuss how Democrat policy failures in Washington D.C. have warped the American health care system and hurt patients access to high-quality health coverage options.

“Many patients have fewer plan choices than they did before Obamacare was enacted. Therefore, Obamacare coverage is not translating to patient or taxpayer affordability,” said Chairman Griffith. “We owe it to patients to have a health system that offers real choices, transparent prices, and coverage that fits their needs, and I look forward to seeing how today’s conversation presents solutions to make health care more affordable for all Americans.”

Watch the full hearing ** here **.

Below are key excerpts from today’s hearing:

Congressman Brett Guthrie (KY-02): “Experts, including the Congressional Budget Office, estimated that the expiration of the temporary Obamacare enhanced COVID Credit is projected to increase premiums by anywhere from 4 percent and 8 percent, depending on the market. Yet, many areas for 2026, insurers requested and were approved for premium increases of 30 percent, 40 percent, even 50 percent. So, Mrs. Boudreaux, you’re in Kentucky. The average Elevance Obamacare plan increased its premium by roughly 24 percent. Despite what Democrats would have the American people believe, the temporary COVID Credit does little to actually lower underlying Obamacare premiums and the American taxpayers are footing the bill. So, Mrs. Boudreaux, by your best estimation—even if the Democrats’ temporary COVID Credits were extended—would Obamacare plan bids in my state of Kentucky increase or decrease between 2026 and 2025?” Mrs. Boudreaux: “Well, thank you very much for the question, Congressman. You know, as we’ve shared, premiums reflect the underlying costs...” Chairman Guthrie: “So, they would have increased, right?”

Congressman John Joyce, M.D. (PA-13): “Since the passage of the ACA, we have seen costs across all markets continue to increase. One of the key issues driving this is the medical loss ratio, or the MLR, that requires plans to spend either 80 percent or 85 percent of your premium dollars on health care expenses. The MLR created multiple perverse incentives for insurance companies to dramatically consolidate both vertically and horizontally. The companies that you lead today are not just involved in insurance. You own PBMs, you own specialty pharmacies, you own retail pharmacies, you own GPOs, you own physician groups and practices. In some cases, you own hospitals, and you own drug manufacturing companies. And at least one of you owns a bank! This has led to alleged cases of self-dealing, as your companies work to circumvent the [multi-level marketing] requirements.”

Congresswoman Mariannette Miller-Meeks (IA-01): “The largest PBMs—CVS Caremark, Express Scripts, and Optum—have created rebate contracting entities, or PBM group purchasing organizations, which are adding to the complex and opaque nature of the medicine supply chain. My first PBM reform bill on transparency was in 2019, as an Iowa state senator. PBMs claim these entities provide them and their clients with greater bargaining power to lower costs, but recent investigations by Members of Congress, industry experts, state attorneys general, and federal oversight agencies suggest the opposite may be true. We have a graph up here. Let’s start with the left. The drugmaker pays rebates directly to the PBMs and PBM GPOs to ensure their drugs are included on their health plan formularies—meaning the drugs are covered by insurance. Then, these PBMs and their PBM GPO subsidiaries collect the rebates, which they promise to pass through to their patients and health plans. Can any of you tell me what percentage of rebates are passed through to the patient, who is paying a higher drug cost because the rebates are added to the price of the drug?” Top Health Insurers: “...” Congresswoman Miller-Meeks: “Is it zero?” Top Health Insurers: “...” Congresswoman Miller-Meeks: “You don’t even know that you’re not giving these patients back a rebate for paying higher drug prices.”

WASHINGTON, D.C. – This week, the House Committee on Energy and Commerce is holding two Subcommittee Hearings and one Full Committee Markup. Read more below.

FULL COMMITTEE MARKUP: The Committee on Energy and Commerce will hold a markup of 11 bills.

• DATE: Wednesday, January 21, 2026
• TIME: 10:15 AM ET
• LOCATION: 2123 Rayburn House Office Building

SUBCOMMITTEE HEARING: The Energy and Commerce Subcommittee on Health is holding a hearing to have productive discussions with health insurance companies on the core drivers working against health care affordability—namely onerous government interference, administrative burdens, waste, fraud, and abuse, and lack of competition and patient choice.

• DATE: Thursday, January 22, 2026
• TIME: 9:45 AM ET
• LOCATION: 2123 Rayburn House Office Building

SUBCOMMITTEE HEARING: The Energy and Commerce Subcommittee on Environment is holding a hearing to discuss legislation to modernize America’s Chemical Safety Law.

• DATE: Thursday, January 22, 2026
• TIME: 2:00 PM ET
• LOCATION: 2123 Rayburn House Office Building

WASHINGTON, D.C. – Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, Congressman John Joyce, M.D. (PA-13), Chairman of the Energy and Commerce Subcommittee on Oversight and Investigations, Congressman Morgan Griffith (VA-09), Chairman of the Energy and Commerce Subcommittee on Health, Congressman Jason Smith (MO-08), Chairman of the House Committee on Ways and Means, Congressman David Schweikert (AZ-01), Chairman of the Ways and Means Subcommittee on Oversight, and Congressman Vern Buchanan (FL-16), Chairman of the Ways and Means Subcommittee on Health, authored ** a letter ** to the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) requesting a meeting on the concerning evidence detailed in the letter that points to large-scale, ongoing Medicare fraud in Los Angeles County, along with what action is being taken to address the situation.

“The House Committee on Energy and Commerce has an extensive history of digging deeper into matters where program integrity has been compromised. This letter is crucial in our commitment to eliminating waste, fraud, and abuse in federal health care programs,” said Chairmen Guthrie, Joyce, and Griffith. “Republicans have spent much of this Congress furthering legislation to protect our most vulnerable Americans—especially seniors, but our work is not done. Continued oversight is crucial to uphold the integrity of programs that serve our most vulnerable populations. We applaud the ongoing work being conducted by HHS-OIG in cracking down on the fraud that has occurred, and we look forward to addressing the larger-scale scheme that is draining public resources from Americans who need these services the most.”

“Medicare home health and hospice fraud directly undermines the safety and reliability of care for America’s most vulnerable seniors. Auditors have reported an unprecedented jump in home health and hospice fraud in Los Angeles County, California – including one report showing 112 different hospices located at the same physical address. With $1.2 billion in improper payments in home health claims and the Inspector General reporting $198 million in suspected hospice fraud, Gavin Newsom’s California could just as well be another Minnesota,” said Chairman Smith. “The Ways and Means Committee will not hesitate to use our broad oversight authority to get to the bottom of this and protect taxpayers and vulnerable patients against these bad actors.”

BACKGROUND:

Evidence has strongly suggested large-scale Medicare fraud involving home health agencies (HHA) and hospice agencies in Los Angeles County, California, noting that such practices not only drain public resources but also compromise the quality of care provided to patients, especially those most vulnerable populations.

• The Centers for Medicare and Medicaid Services (CMS) found that the 2023 improper payment error rate for home health claims was 7.7 percent, or about $1.2 billion, in 2023.
• In terms of hospice care, HHS OIG reported suspected hospice fraud to be an estimated $198.1 million in fiscal year (FY) 2023.
• CMS has placed HHAs as an area of high risk for Medicare fraud.

Emerging concerns over Medicare fraud in the HHAs and hospice sector highlights heightened activity, specifically in Los Angeles County.

• From 2019 through June 2023, HHAs in the U.S. decreased from 8,838 to 8,280 (6 percent), while, at the same time, HHAs in Los Angeles County increased from 896 to 1,309 (46 percent).
• More than 1,400 new Los Angeles County HHAs enrolled in Medicare in the last five years, representing over 50 percent of all HHAs in the state of California and nearly 14 percent of all HHAs in the country.

Based on data from the March 2022 California State Auditor’s Report and from HHS on hospice ownership, Los Angeles County had more than 31 percent of the hospice agencies in the U.S. in 2022.

• There were approximately 58 million seniors in the U.S. in 2022, with Los Angeles County having approximately 1.49 million seniors (2.5 percent).
• The report highlighted indicators that included a “rapid, disproportionate growth in the number of hospice agencies” and “excessive geographic clustering of hospice agencies,” noting that 112 different licensed hospice agencies were located at the same physical address.
• State auditors in California estimated that hospice agencies in Los Angeles County likely overbilled Medicare by $105 million in 2019.

These accounts of widespread fraud occurring in Los Angeles County’s HHAs and hospice agencies have raised concerns about whether home health and hospice Accrediting Organizations (AO) are effectively examining such organizations at the time of their enrollment in Medicare.

• In November 2024, CMS issued a Quality, Safety, and Oversight memo to surveyors, reminding them to closely inspect hospices’ Medicare enrollment documents to understand changes in ownership and location, but neglecting to encourage AOs to pursue other commonsense antifraud measures.

In April 2025, HHS OIG announced that the Office of Audit Services would compile a report for FY 2026 to identify trends, patterns, and comparisons that could indicate potential vulnerabilities related to new Medicare hospice provider enrollments.

In May 2025, the Health Care Fraud Strike Force—a joint task force of federal, state, and local law enforcement agencies, including HHS OIG—** announced multiple arrests ** following a multi-year investigation into Armenian Organized Crime, which dismantled five hospices in the greater Los Angeles area.

On November 28, 2025, CMS ** announced ** the Calendar Year 2026 Home Health Prospective Payment System Final Rule, providing comments that suggest an interest in addressing the aforementioned accounts of fraud.

WASHINGTON, D.C.  – House Committee on Energy and Commerce Chairman Brett Guthrie (KY-02) and Ranking Member Frank Pallone Jr., (NJ-06), along with Energy and Commerce Subcommittee on Oversight and Investigations Chairman John Joyce, MD (PA-13), and Ranking Member Yvette D. Clarke (NY-09), wrote to the Health Resources and Services Administration (HRSA) requesting a briefing on its ongoing oversight of patient safety in our nation’s organ procurement and transplant system.   In July, the Committee’s Oversight and Investigations Subcommittee held a hearing in response to a HRSA investigative report that found patient safety concerns at Kentucky Organ Donor Affiliates (KYDA) – the organ procurement organization (OPO) serving the state of Kentucky. In the investigative report, HRSA revealed that of the 351 cases reviewed, 103 cases (29.3 percent) showed “concerning features.” These concerning features included problems with patient-family interactions, medical assessments and team interactions, recognition of high neurologic function, and recognition and documentation of drugs in records.   In addition, HRSA issued a corrective action plan to address the findings in its report specific to KYDA and directing the Organ Procurement and Transplantation Network (OPTN) Board of Directors to develop certain safety guidelines for the entire OPTN. The corrective action plan raised further questions about the possibility that there may be more systemic issues at OPOs across the country, noting that “ [s]ince the review of KYDA was initiated, HRSA has received reports of similar patterns of high risk [donation after circulatory death] procurement practices at other OPOs .” Moreover, during the July hearing, HRSA’s Organ Transplant Branch Chief, Dr. Raymond Lynch was questioned about the potential failure to adhere to existing protocols by Rep. Erin Houchin (IN-09): “ is it a broader systemic issue or is it limited to KYDA ?” Dr. Lynch responded that “ [u]nfortunately, it is not limited to KYDA. During the course of this investigation we received concerns that were in areas served by other OPOs. ”  Chairmen Guthrie and Joyce and Ranking Members Pallone and Clarke issued the following joint statement:    “ The Committee’s examination of the organ procurement and transplant system has demonstrated the need for further oversight.  Testimony from the July hearing, HRSA’s investigative report and corrective action plan, and continued reports of similar patterns at other OPOs all raise serious concerns. The American people should be able to have full faith and confidence in our organ donor and transplant system, and we will continue to work together to prevent these harmful practices from continuing. Americans’ confidence in the system comes when patient safety is protected. ”    Read the full letter  here . Background:  ·       During the 118th Congress, the Committee on Energy and Commerce  passed  the Securing the U.S. Organ Procurement and Transplantation Network Act to both modernize the OPTN and allow HRSA to institute a competitive contracting process to find the best contractors for various OPTN functions. This legislation was signed into law on September 22, 2023.   ·       On March 20, 2024, the Committee  launched an investigation  into the organ procurement and transplantation system by sending  a letter  to United Network for Organ Sharing (UNOS) requesting information related to concerns surrounding data security and operability, patient safety and equity, and conflicts of interest.    ·       On March 20, 2024, the Committee also sent  a letter  to HRSA requesting information related to implementation of the Securing the U.S. Organ Procurement and Transplantation Network Act as well as other concerns related to effective oversight and management.   ·       On September 11, 2024, the Subcommittee on Oversight and Investigations held a  hearing  that focused on the implementation of reforms at the OPTN, including the need for stronger oversight and accountability as well as ongoing patient safety concerns.   ·       During the hearing, questions were raised related to allegations of mismanagement and patient safety concerns after patients began exhibiting signs of increased neurologic function after being previously deemed suitable as an organ donation candidate. Several of these allegations, particularly those related to patient safety, were later substantiated through the findings contained in HRSA’s March 2025 report.   ·       On March 24, 2025, HRSA’s Division of Transplantation issued a  report  that summarized the findings of its investigation into KYDA, the OPO now known as Network for Hope, which serves Kentucky and parts of Ohio, West Virgina, and Indiana.  ·       On May 28, 2025, HRSA issued a  CAP  to OPTN, which directed the OTPN to take specific actions within a specified period of time, including developing a 12-month OPTN monitoring plan for KYDA to address concerns identified. The corrective action plan also requires the OPTN to propose policies for public comment to improve safeguards for potential donation after circulatory death (DCD) patients in the organ procurement process and increase information shared with patient families regarding DCD organ procurement.   ·       On July 22, 2025, the House Committee on Energy and Commerce’s Subcommittee on Oversight and Investigations held a  hearing  examining concerning practices within our nation’s organ procurement and transplant system that were identified by HRSA’s investigation.   ###

WASHINGTON, D.C. – Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, along with Reps. Palmer (AL-06), Carter (GA-01), Bilirakis (FL-12), and Obernolte (CA-23), penned a letter to the Executive Director of Covered California (CoveredCA), Jessica Altman, to request further information related to the potentially unauthorized transmission of sensitive personal health information involving Covered California’s website. Key Letter Excerpt: “According to public reports and agency statements, tracking technology was embedded on Covered California's website beginning in February 2024, as part of a broader digital advertising effort, and in direct contravention of the tracking platform’s user agreement, which prohibits the use of such tools on pages that collect sensitive health information. Although the tags were reportedly removed in April 2025, following external scrutiny and a vendor transition, the extended period of data exposure raises serious questions about the adequacy of safeguards that Covered California had in place. Forensic testing by investigative reporters identified the trackers in operation and confirmed that user-entered health information was being transmitted to third parties without consent. These circumstances warrant examination of Covered California’s actions under federal privacy standards.” “Ensuring the confidentiality of health information is a foundational obligation for entities operating within the health insurance ecosystem. Federal privacy protections, particularly the Health Insurance Portability and Accountability Act (HIPAA), establish expectations for how covered organizations handle sensitive data. Recent reports and public filings raised questions about whether those expectations were met in this case, and whether existing oversight mechanisms are sufficient to detect and prevent improper disclosures.” Background: Forensic testing shows Covered California —the State of California’s official health insurance marketplace—has been sending sensitive user health data to third-party websites through several online data trackers. Prior to removal of the trackers, CoveredCA had more than 60 trackers active on its website; the average number of trackers on a government website is three. Some types of information sent to such websites include: Searches for doctors in network with specific plans/specializations Demographic information, including gender, ethnicity, and marital status Length of treatment a patent received by a provider Frequency of doctor visits If the user indicated they were blind, pregnant, a victim of domestic abuse, or used prescription medications. The State of California independently operates CoveredCA. As the state’s official ACA marketplace, CoveredCA falls under the purview of Health Insurance Portability and Accountability Act (HIPAA). The disclosure of information such as pregnancy or prescription drug use without proper consent—even for “marketing purposes”—may violate HIPAA. This Congress, the Committee has sent letters to 23andMe and DeepSeek over potential data privacy concerns: The Committee also held a hearing last Congress on the Change Healthcare hack, where personal health information was also jeopardized. CLICK HERE to read Fox News coverage of the letter. CLICK HERE to view the full letter. ###