House Panels Summon Top Insurers for Rare Double Hearing as ACA Subsidies Expire and Premiums Spike

Hartford, Connecticut — The health insurance bill for a 40-year-old graphic designer more than tripled on Jan. 1. Her monthly premium for an Affordable Care Act (ACA) marketplace plan jumped from about $324 to $1,061 after extra federal subsidies expired at the end of 2025, state officials say.

On Jan. 22, the executives who help set those prices will be called to explain themselves before Congress.

Insurers called for a rare two-panel appearance

The chairs of the House Energy and Commerce Committee and the House Ways and Means Committee have summoned the chief executives of five of the country’s largest health insurers for a rare one-day, two‑panel grilling on rising premiums and the affordability of commercial coverage.

Stephen Hemsley of UnitedHealth Group, David Joyner of CVS Health, David Cordani of The Cigna Group, Gail Boudreaux of Elevance Health and Paul Markovich of Ascendiun, the parent of Blue Shield of California, are scheduled to testify in the morning before Energy and Commerce and again in the afternoon before Ways and Means.

House Republicans say they want answers about why coverage costs so much — not only for people who buy plans on the ACA marketplaces, but also for the roughly 154 million Americans covered through employers.

“House Republicans are once again left to clean up the mess of Democrats’ flawed policymaking,” Energy and Commerce Chair Brett Guthrie of Kentucky and Ways and Means Chair Jason Smith of Missouri said in a joint statement announcing the hearing. Instead of “temporarily bailing out a failing program utilized by a fraction of the country,” they said, the committees will probe “rising costs, the current state of health care affordability, and the role played by large health insurers.”

Subsidy lapse drives sharp marketplace increases

The hearing comes at a volatile moment for the health system and for Congress. Enhanced premium tax credits that had held down costs for ACA enrollees since 2021 expired on Dec. 31, 2025, after lawmakers failed to agree on an extension before the deadline. Analysts estimate that, as a result, average net premiums for subsidized marketplace customers will more than double this year.

Researchers at KFF, a nonpartisan health policy group, project that the average subsidized enrollee’s annual premium payment will jump from about $888 to roughly $1,900 or more in 2026 — an increase of around 114%. Older consumers and middle‑income households just above the previous subsidy cutoff of 400% of the federal poverty level are expected to be hit hardest.

States are already reporting the impact. In Connecticut, officials said that without new state aid, a single person earning $68,000 would see their monthly premium spike from $324 to $1,061 when the extra federal help disappears. The state approved a $70 million stop‑gap program to blunt the increase.

Democrats argue that the decision by the Republican‑controlled House not to secure an earlier deal on subsidies is the main reason families are facing sudden sticker shock.

“Because Republicans refused to extend the premium tax credits, they expired at the end of 2025,” Rep. Frank Pallone Jr. of New Jersey, the top Democrat on the Energy and Commerce Committee, said at a recent hearing. “Now insurance premiums are skyrocketing by two, three, and even four times for 24 million Americans.”

Competing bills, competing narratives

On Jan. 8, under pressure from constituents and with open enrollment chaos looming, the House approved a Democratic bill to reinstate the enhanced ACA subsidies in a 230‑196 vote. Seventeen Republicans joined all voting Democrats in backing the measure. The nonpartisan Congressional Budget Office estimated the 10‑year cost of restoring the more generous tax credits at about $80.6 billion and projected that roughly 6.2 million more people would gain coverage if they were extended.

Republican leaders opposed the legislation and instead point to their own proposal, the Lower Health Care Premiums for All Americans Act. That bill, which passed the House in December on a party‑line vote, would fund cost‑sharing reduction payments to insurers, expand association health plans, loosen rules on stop‑loss coverage for small employers and impose new transparency requirements on pharmacy benefit managers (PBMs).

Citing CBO estimates, bill supporters say those changes would reduce “gross benchmark premiums” in the individual market by about 11% and save taxpayers around $30 billion compared with continuing the enhanced subsidies. Critics note that those figures do not reflect what consumers actually pay out of pocket when tax credits shrink or disappear.

“Taxpayers are paying more and getting less,” Rep. Lloyd Smucker, a Pennsylvania Republican and supporter of the GOP bill, said in a statement. “Insurance companies reap the most benefits, while patient outcomes have not improved in proportion.”

Rep. Greg Murphy, Republican of North Carolina, has described the enhanced ACA credits as “temporary COVID‑era Obamacare subsidies” that turned into a “bailout” for “greedy insurance companies.” Republicans say they want to focus on what they call underlying cost drivers — including hospital and drug prices, consolidation, and the behavior of insurers and PBMs — rather than rely on what they view as open‑ended subsidies.

Executives face scrutiny beyond premiums

The insurers arriving on Capitol Hill will do so amid intense scrutiny of their own practices.

UnitedHealth, the country’s largest health insurer by revenue, is under civil and criminal investigation by the Department of Justice over allegations it used diagnosis coding in its Medicare Advantage plans to improperly boost payments from the federal government. UnitedHealth has said it is cooperating with investigators.

A Senate investigation led by Sen. Richard Blumenthal of Connecticut last year found that UnitedHealthcare, Humana and CVS Health’s Aetna unit each denied prior authorization requests for post‑acute care in Medicare Advantage at much higher rates than for other services between 2019 and 2022. The report said denial rates increased as the companies relied more heavily on algorithmic tools and accused the insurers of “intentionally using prior authorization to boost profits by denying post‑acute care” for vulnerable seniors. The companies disputed that characterization and said they follow Medicare rules.

UnitedHealth also spent much of the past two years dealing with the fallout from a massive cyberattack on its Change Healthcare subsidiary that disrupted claims payments across the system, as well as leadership turmoil and sharp swings in its stock price.

Ascendiun, which will share the witness table with the national for‑profit carriers, is itself the product of a controversial restructuring. California regulators recently approved a plan allowing Blue Shield of California to place its health plan and related entities under Ascendiun, a new nonprofit parent incorporated out of state. Consumer advocates warned the move could make it harder for California to oversee billions in charitable assets. Blue Shield and Ascendiun said the new structure would help them invest more flexibly and “make health care more affordable.”

Employer coverage costs continue to rise

Even for Americans with job‑based insurance, costs have been climbing. The average annual premium for employer‑sponsored family coverage reached $26,993 in 2025, according to national survey data, up 6% from the year before. Workers contributed about $6,850 toward those premiums on average, and many face high deductibles and other out‑of‑pocket charges.

Republicans say that is why they framed the Jan. 22 hearings around “all Americans with commercial insurance coverage, not just the small percentage who obtain their health insurance through the ACA.”

Democrats are expected to press the executives on a different set of issues: the impact of the subsidy lapse on enrollment, alleged overpayments in Medicare Advantage, the use of artificial intelligence in coverage decisions, and executive compensation and share buybacks at a time when households are struggling with higher bills.

Political backdrop and uncertain outcomes

The hearings will unfold against a broader political backdrop. Former President Donald Trump said this week that he plans to meet with representatives of 14 major insurers “in a few days” to push them to lower prices. Trump has long predicted that the Affordable Care Act will “repeal itself” and has urged Republicans to “own health care,” though he has not laid out a detailed replacement plan.

For now, families and small businesses are caught between rising underlying medical costs, shifting federal subsidies and a bitterly divided Congress. Whether the Jan. 22 sessions lead to concrete changes — in how insurers are regulated, how subsidies are structured or how the government pays for Medicare Advantage — remains unclear.

What is certain is that, for a day at least, five executives at the center of the nation’s health insurance system will be under klieg lights, asked to explain why profits are robust, premiums are higher and more Americans feel priced out of coverage.