Late last month, the chief executives of some of the nation’s largest insurance companies — UnitedHealth, CVS, Cigna, Elevance, and the California Blues — trekked to Capitol Hill for a day of hearings where federal lawmakers probed one of the most pressing issues of the day: health care affordability.
There was plenty of ire to go around. Some of the words members of Congress used to describe insurance companies’ care delays and denials, vertical consolidation, and sky-high executive compensation: “Unconscionable.” “Criminal.” “Just plain wrong.”
The data support some of their views. Through their business practices, commercial insurers have accrued substantial financial resources while costs rise in the health care system. Collectively, just seven of the largest insurers nationally amassed an astounding $34.1 billion in net profit in 2024, and those profits have grown at an extraordinary rate. For example, from 2000 to 2024, UnitedHealth Group’s annual revenue increased by nearly 1,800% ($379 billion), while its net profit increased by 1,860% ($14 billion).
For much of the day on the Hill, and in materials distributed a couple of weeks ago, the insurance companies tried to deflect — pointing the finger at hospitals, pharmaceutical companies, and costly weight loss drugs.
By many accounts, the response has fallen flat. Federal policymakers are hearing and understanding things that hospitals know very well:
- Commercial insurance companies are middlemen — they are not involved in patient care and, evidenced by intentionally complex prior authorization processes and denials that contradict clinical guidance — serve as a barrier to care rather than a facilitator of care.
- Hospital care takes substantial resources, in service of better treatment for patients. From investments in health care workers’ wages to advancements in cancer treatments and trauma care to extensive training for health care professionals, hospitals save lives every day. That takes a highly trained, highly specialized, and yes — costly — care team to make the impossible, possible.
On this last point, the congressional hearings are not finished, and hospitals, too, will have an opportunity to answer tough questions about why health care is so costly in the United States in 2026. Indeed, cost tops Americans’ concerns about the health care system, with 29% citing health care costs as the most urgent national health problem, according to a recent Gallup poll.
But hospitals have an important story to tell when they have a turn. It has two parts.
The first is that the nation’s hospitals have, for decades and decades, been there for their communities. They are there to massage hearts to keep people alive. They are there to repair bodies broken by trauma. They are there, stalwart pillars in their communities — homes to solid, stable jobs, to refuge for those with nowhere else to go, and to hope for those in the darkest moments of their lives.
The second — and this can’t be overstated — is that due to an unprecedented cut to federal Medicaid spending over the next decade, hospitals must now prepare for drastic reductions in resources and an increase in uncompensated care, calling into question their ability to continue to care for their communities and their valued health care employees. In other words, the federal government has ALREADY cut hospital care to the bone, and dozens of hospitals in our state are at significant risk of closure. Any more and the system could well collapse.
We’ll be there when it’s our turn to tell this story, working with our partners at the American Hospital Association, because we know that hospitals are worth fighting for, and no amount of finger-pointing by insurance companies will change that.
