[House Hearing, 119 Congress]
[From the U.S. Government Publishing Office]
LOWERING THE COST OF HEALTHCARE:
TECHNOLOGY'S ROLE IN
DRIVING AFFORDABILITY
=======================================================================
JOINT HEARING
before the
SUBCOMMITTEE ON ECONOMIC GROWTH, ENERGY POLICY, AND REGULATORY AFFAIRS
and the
SUBCOMMITTEE ON HEALTH CARE AND FINANCIAL SERVICES
of the
COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM
U.S. HOUSE OF REPRESENTATIVES
ONE HUNDRED NINETEENTH CONGRESS
FIRST SESSION
__________
DECEMBER 10, 2025
__________
Serial No. 119-51
__________
Printed for the use of the Committee on Oversight and Government Reform
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Available on: govinfo.gov, oversight.house.gov or docs.house.gov
_______
U.S. GOVERNMENT PUBLISHING OFFICE
62-183 PDF WASHINGTON : 2026
COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM
JAMES COMER, Kentucky, Chairman
Jim Jordan, Ohio Robert Garcia, California, Ranking
Mike Turner, Ohio Minority Member
Paul Gosar, Arizona Eleanor Holmes Norton, District of
Virginia Foxx, North Carolina Columbia
Glenn Grothman, Wisconsin Stephen F. Lynch, Massachusetts
Michael Cloud, Texas Raja Krishnamoorthi, Illinois
Gary Palmer, Alabama Ro Khanna, California
Clay Higgins, Louisiana Kweisi Mfume, Maryland
Pete Sessions, Texas Shontel Brown, Ohio
Andy Biggs, Arizona Melanie Stansbury, New Mexico
Nancy Mace, South Carolina Maxwell Frost, Florida
Pat Fallon, Texas Summer Lee, Pennsylvania
Byron Donalds, Florida Greg Casar, Texas
Scott Perry, Pennsylvania Jasmine Crockett, Texas
William Timmons, South Carolina Emily Randall, Washington
Tim Burchett, Tennessee Suhas Subramanyam, Virginia
Marjorie Taylor Greene, Georgia Yassamin Ansari, Arizona
Lauren Boebert, Colorado Wesley Bell, Missouri
Anna Paulina Luna, Florida Lateefah Simon, California
Nick Langworthy, New York Dave Min, California
Eric Burlison, Missouri Ayanna Pressley, Massachusetts
Eli Crane, Arizona Rashida Tlaib, Michigan
Brian Jack, Georgia James R. Walkinshaw, Virginia
John McGuire, Virginia
Brandon Gill, Texas
------
Mark Marin, Staff Director
James Rust, Deputy Staff Director
Ryan Giachetti, Chief Counsel
Jack Furla, Counsel
Kylie Hinojosa, Professional Staff Member and Administrative Clerk
Ellie McGowan, Professional Staff Member and Administrative Clerk
Mallory Cogar, Director of Operations and Chief Clerk
Contact Number: 202-225-5074
Robert Edmonson, Minority Staff Director
Contact Number: 202-225-5051
------
SUBCOMMITTEES
----------
Subcommittee on Economic Growth, Energy Policy, and Regulatory Affairs
Eric Burlison, Missouri, Chairman
Gary Palmer, Alabama Maxwell Frost, Florida, Ranking
Clay Higgins, Louisiana Member
Byron Donalds, Florida Yassamin Ansari, Arizona
Scott Perry, Pennsylvania Dave Min, California
Lauren Boebert, Colorado Ro Khanna, California
------
Subcommittee on Health Care and Financial Services
Glenn Grothman, Wisconsin, Chairman
Paul Gosar, Arizona Raja Krishnamoorthi, Illinois,
Pete Sessions, Texas Ranking Member
Anna Paulina Luna, Florida Emily Randall, Washington
John McGuire, Virginia Wesley Bell, Missouri
Brandon Gill, Texas Lateefah Simon, California
C O N T E N T S
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OPENING STATEMENTS
Page
Hon. Eric Burlison, U.S. Representative, Chairman................ 1
Hon. Maxwell Frost, U.S. Representative, Ranking Member.......... 3
Hon. Glenn Grothman, U.S. Representative, Chairman............... 5
Hon. Raja Krishnamoorthi, U.S. Representative, Ranking Member.... 6
WITNESSES
Mr. Brian Whorley, Chief Executive Officer, Paytient
Technologies, Inc.
Oral Statement................................................... 8
Dr. Darius Lakdawalla, Quintiles Chair in Pharmaceutical
Development and Regulatory Innovation and Chief Scientific
Officer, Schaeffer Center for Health Policy and Economics,
University of Southern California
Oral Statement................................................... 9
Dr. Ziad Obermeyer, Blue Cross of California Distinguished
Associate Professor, Health Policy and Management, company,
University of California-Berkeley
Oral Statement................................................... 11
Mr. Chris Jacobs, Founder, Juniper Research Group
Oral Statement................................................... 13
Ms. Sophia Tripoli (Minority Witness), Senior Director of Health
Policy, Families USA
Oral Statement................................................... 14
Written opening statements and bios are available on the U.S.
House of Representatives Document Repository at:
docs.house.gov.
INDEX OF DOCUMENTS
* Article, Juniper Research Group, ``No, Obamacare Premiums are
NOT Doubling in 2026''; submitted by Rep. Burlison.
* Article, Center on Budget and Policy Priorities, ``By the
Numbers Harmful Republican Megabill''; submitted by Rep. Frost.
* Article, The Hill, ``Medicaid Cuts Will Harm Rural Republican
Communities the Most''; submitted by Rep. Frost.
* Fact Sheet, Keep Americans Covered, ``Preserve Health Care
Tax Credits''; submitted by Rep. Frost.
* Report, Commonwealth Fund, ``Expiring ACA Premium Tax Credits
Could Lead to Nearly 340,000 Jobs Lost''; submitted by Rep.
Frost.
* Article, Unleash Prosperity, ``How Much Does That MRI Cost'';
submitted by Rep. Grothman.
* Article, AMA, ``Trends in Health Care Spending''; submitted
by Rep. Grothman.
* Fact Sheet, CMS, ``National Health Expenditures''; submitted
by Rep. Grothman.
* Article, Jaisri Lingappa, ``How WISeR Will Enable Companies
to Profit From Pain--A Retired Physician's Story''; submitted
by Rep. Randall.
The documents listed above are available at: docs.house.gov.
LOWERING THE COST OF HEALTHCARE:
TECHNOLOGY'S ROLE IN
DRIVING AFFORDABILITY
----------
WEDNESDAY, DECEMBER 10, 2025
U.S. House of Representatives
Committee on Oversight and Government Reform
Subcommittee on Economic Growth, Energy Policy, and Regulatory Affairs
Subcommittee on Health Care and Financial Services
Washington, D.C.
The Subcommittees met, pursuant to notice, at 10:04 a.m.,
in room HVC-210, Capitol Visitor Center, Hon. Eric Burlison
[Chairman of the Subcommittee on Economic Growth, Energy
Policy, and Regulatory Affairs] presiding.
Present: Representatives Burlison, Grothman, Higgins,
Donalds, Perry, McGuire, Gill, Comer, Frost, Krishnamoorthi,
Randall, Bell, and Simon.
Mr. Burlison. This joint hearing of the Subcommittee on
Economic Growth, Energy Policy, and Regulatory Affairs and the
Subcommittee on Health Care and Financial Services will come to
order.
Welcome, everybody.
Without objection, the Chair may declare a recess at any
time.
I recognize myself for the purpose of making an opening
statement.
OPENING STATEMENT OF CHAIRMAN ERIC BURLISON
REPRESENTATIVE FROM MISSOURI
Welcome to this joint hearing of the Subcommittee on
Economic Growth, Energy Policy, and Regulatory Affairs and the
Subcommittee on Health Care and Financial Services. Today, we
are here to explore how innovative technology in the healthcare
sector can help lower Americans' healthcare costs.
Healthcare costs in the United States have long been on the
rise, but recent Democrat policies and the radical Biden
Administration's regulatory agenda have made healthcare costs
in America even worse.
The Inflation Reduction Act, or the IRA, signed into law by
the Biden Administration in 2022, was passed under the guise of
lowering healthcare costs for working Americans.
These two Subcommittees recently held a joint hearing on
the ballooning costs and the market-distorting policies
included in the IRA. Today, we have another opportunity to take
a hard look at the consequences of policies that not only
failed to accomplish their intended goals but place an undue
regulatory burden on Americans.
Business owners in our country put their livelihoods on the
line to develop breakthrough technologies to reinvent the
healthcare industry but are forced constantly to navigate the
regulatory obstacles put in place by Democrat administrations.
The money spent on legal fees and administrative procedures
could be reinvested to further improve technologies that
doctors and other medical providers can use to improve patient
experiences, save lives, and bring families together.
Congress must give private sector innovators the space and
the resources that they need to develop these technologies.
We have already begun to see the tremendous capabilities of
artificial intelligence to help lower costs in our everyday
lives. If that power were harnessed in the healthcare sector,
resources could be more effectively deployed to help patients
get better.
In addition, lower costs would save the Federal Government
and the taxpayers a lot of money in any of our Federal
healthcare programs.
For example, patients can use wearable technology to
monitor their health. These devices assist doctors and
researchers with realistic data on their patients day to day in
real time.
3D printing can create personalized medical devices for
individual patients. Investment in this printing technology has
led to the development of customized prosthetics, implants, and
surgical tools.
Telehealth improves the efficiency of healthcare by
allowing medical providers to serve patients in a live virtual
call. Telehealth saves time and helps patients connect to their
doctors, especially in rural areas where there are few medical
facilities.
These kinds of technologies are revolutionary, but if
innovators cannot afford to develop more of them because of the
expensive barriers put in place by the previous administration
and the Inflation Reduction Act, the American people will miss
out on cutting-edge medical care that could improve patient
outcomes.
Earlier this year, President Trump signed the One Big
Beautiful Bill into law. That bill gives over $50 billion to
rural hospitals to ensure their continued operation and
development of medical technology.
Since entering office, President Trump has taken decisive
action aimed at reversing innovation-stifling Biden-era
policies in artificial intelligence, promoting transparent drug
pricing, and eliminating the ``Biden Pill Penalty.''
Our expert panel of witnesses, including a fellow
Missourian and a medical technology business owner, will
provide testimony on this important issue.
I thank all of the witnesses for being here today, and I
look forward to our discussion.
And with that, I yield to Ranking Member Frost for his
opening statement.
OPENING STATEMENT OF MAXWELL FROST
REPRESENTATIVE FROM FLORIDA
Mr. Frost. Thank you, Chairman Burlison and Chairman
Grothman, and thank you to the witnesses for being here this
afternoon.
I have got to be honest, I was a little shocked to see this
hearing called on healthcare affordability this week as we
continue to see congressional Republicans block extension of
the tax credits that will help people obtain affordable
healthcare.
We, as in this moment, are in a crisis. In just five weeks,
the Affordable Care Act, ACA, enrollment period ends, and
189,000 people in my district alone will be paying anywhere
between 50 and 300 percent more in premiums, and many will opt
out of coverage altogether.
So, we can hold a hearing about whether technology for new
software and medical tools can decrease costs. It is very
interesting. I would appreciate that conversation and support
innovation in the way that we deliver healthcare.
But to hold this hearing now while ignoring the massive
upcoming cliff in front of us right now is, quite frankly, an
insult to the 25 million Americans that will see their
healthcare costs go up if Congress does not do its job.
Healthcare costs are going to skyrocket for American
families if people cannot afford their premiums, and using
technology to make certain procedures or processes slightly
more efficient will not change that.
We cannot allow the costs of treating cancer, diabetes,
heart disease, and any other condition to people we know and
people we love that are battling every day to bankrupt
hardworking Americans.
I cannot imagine trying to convince my constituents who are
about to be paying an additional $2,000 a month in healthcare
premiums that giving money to tech companies will knock off a
few dollars here and there and that it is the best their
leaders can do for them.
It is not just my district. Millions of people across the
country are unsure whether they can afford healthcare coverage
as premiums and deductibles rise.
One in four Americans who currently rely on the Affordable
Care Act for health insurance are at risk of losing coverage if
congressional Republicans succeed in letting these tax credits
expire.
Most Americans who are enrolled in the Affordable Care Act
will see their healthcare insurance premiums increase anywhere
from 50 to 300 percent. And at the same time, congressional
Republicans have taken a sledgehammer to our healthcare system
and set us on a path to undo all the gains that made healthcare
more affordable under Democratic leadership.
President Trump's One Big Beautiful Bill Act takes
healthcare coverage away from a whopping 15 million Americans.
The single biggest legislative achievement of congressional
Republicans and President Trump this year has been to rip
Medicaid away from almost eight million people by 2034.
Congressional Republicans and Donald Trump, seems like, do not
care whether or not you can afford your healthcare or medical
care, and we have got to be clear this issue is fixable.
The healthcare crisis that congressional Republicans and
Donald Trump have created have real and devastating
consequences for Americans. Patients will go without the
preventative and primary care that they need. One in three
young Americans are at risk of losing their health insurance in
the next few years.
The number of Americans without health insurance coverage
in every state and every congressional district will rise. And
thanks to the work of Donald Trump and congressional
Republicans' new draconian work requirements for Medicaid
eligibility, 2.1 million American women may no longer have
health insurance when they are pregnant or caring for young
children.
And many people, like my Governor, Ron DeSantis, come out
and say that young people, quite frankly, might not need health
insurance if they are under the age of 40.
People who get health insurance through Medicaid or the
Affordable Care Act marketplaces are the same hardworking
Americans that we live and work with every single day. The
Affordable Care Act premium tax credits allow farmers,
ranchers, and small business owners to stay self-employed,
invest in their businesses, and employ others. All these things
strengthen our communities and economy.
Let us not forget that 77 percent of the Affordable Care
Act Marketplace enrollees live in states that President Trump
won in 2024. How quickly has he abandoned them. congressional
Democrats are fighting to make healthcare more affordable. We
are fighting to lower prescription drug prices, and we are
fighting to make sure that all Americans have access to quality
healthcare.
We know we have a broken healthcare system. There is a lot
I personally want to talk about as it relates to this
healthcare system. I personally believe in single payer.
But the fact of the matter is right in front of us we have
a cliff that we are barreling toward, and if we do not do our
job, this whole topic of affordability, I mean, it is something
that 25 million Americans are facing as we speak.
As we learn about innovations in healthcare technology
today, it is important that my congressional Republican
colleagues face the reality that healthcare innovation is not a
substitute for affordable healthcare coverage, and it is not
enough to reduce cost on its own. Innovation cannot reverse the
damage Donald Trump and congressional Republicans have done
with their devastating healthcare cuts.
I urge all of us to keep everyday working families in mind
that are struggling to afford healthcare. Let us ensure that we
pass these premium tax credits. Let us ensure that we do not
hike healthcare costs for 25 million Americans from anywhere
from 50 to 300 percent. And then let us get together and figure
out what we can do in terms of innovation to bring down costs
for all Americans.
Thank you, and I yield back.
Mr. Burlison. I now recognize Chairman Grothman for the
purpose of making an opening statement.
OPENING STATEMENT OF CHAIRMAN GLENN GROTHMAN
REPRESENTATIVE FROM WISCONSIN
Mr. Grothman. Yes, thanks. Just to respond to that a little
bit.
I think it is becoming more and more over time apparent
that the major beneficiary of Obamacare, or the ACA, are the
insurance companies. And we are at a cliff here where we are
going to find out--where we find out what happens when we let
the insurance companies write such a plan.
We are at a point in which we have got to spend $34 billion
a year or more to prop up a failed plan or come up with some
sort of alternative.
So, welcome to this joint hearing of the Subcommittee on
Economic Growth, Energy Policy, and Regulatory Affairs and the
Subcommittee on Health Care and Financial Services. This is an
exciting opportunity for us to address one of the most pressing
issues for Americans: the continued rising cost of healthcare.
Healthcare costs have been steadily increasing since 1970.
The total healthcare spending in the United States was just shy
of $5 trillion a year. That is $14,500 per person. That is
almost 18 percent of GDP. In 1970, healthcare spending
accounted for only seven percent. So, it has increased by 150
percent over the last 50 years.
The United States spends twice as much per person on
healthcare as other peer nations. I do not have statistics on
how much our insurance companies make compared to other
nations.
It makes sense that the overall healthcare costs have
increased in the past 50 years. Our country's population has
grown from 200 million to 350 million.
The problem is not that we are not spending money on
healthcare. The problem is that the money that we are spending
is being wasted and does not improve patient health.
Recent studies show that nearly one-third of healthcare
spending in the United States is wasteful because it does not
lead to better patient outcomes. In 2023, that would mean $1.6
trillion spent on healthcare was wasted.
To put $1.6 trillion in perspective, the Federal Government
spent that same amount on total health insurance in 2024,
including Medicare, Medicaid, Children's Health Insurance
Program (CHIP)s, and the Affordable Care Act marketplace
subsidies.
More than half of this wasteful spending can be directly
attributed to administrative expenses. That is why when you go
into a hospital or a clinic you see a huge number of people
working there who really have nothing directly to do with
healthcare.
Over the past several decades the growth in administrative
staff has far outpaced the growth in doctors and nurses.
Hospitals, insurance companies, and health systems now employ
layers of administrators focusing on billing, compliance,
reporting, coding, and navigating complex regulations rather
than delivering care.
In many hospitals today there are multiple administrative
employees for every practicing physician. These costs are
passed directly to patients through higher prices, higher
premiums, and reduced access to care.
At the same time, patients are left completely in the dark
about prices. Someone scheduling a routine procedure frequently
has no idea what it will cost or how prices compare across
hospitals, clinics, or providers.
In almost no other sector of our economy do consumers face
this level of price secretiveness.
Just imagine how much different our entire healthcare
system would be if more dollars were directed toward patient
care and less toward administration.
This is where technology has the potential to make a real
difference, which is why we felt it was timely to bring in
experts in technology in the healthcare sector and see what
they had to say.
Empowering patients with price transparency can drive
competition, lower costs, and improve access to affordable
care.
Today's expert panel of witnesses will provide their
perspective on how the current healthcare system costs too
much, the leading cause of those rising costs, and how
innovative technology in the healthcare sector will make
healthcare more affordable. We look forward to this testimony.
And with that, I yield to Ranking Member Krishnamoorthi for
his opening statement.
OPENING STATEMENT OF RAJA KRISHNAMOORTHI
REPRESENTATIVE FROM ILLINOIS
Mr. Krishnamoorthi. Thank you, Chair Grothman.
Thank you, Chair Burlison, Ranking Member Frost.
I associate myself with the comments of Ranking Member
Frost, and I just want to point a few things out.
If we do not extend these tax credits that are going to
expire at the end of the year, in Illinois alone half a million
people who receive these tax credits will see, on average,
their premiums go from $260 a month to $464 a month, almost an
80 percent increase.
Looking closer at these numbers, those living in urban
areas will see an almost 90 percent increase in premiums;
whereas, people in rural areas would see premiums rise by a
stunning 107 percent on average. So, doubling their premiums.
Let us be clear. People will not stop needing medical care.
Safety net and rural hospitals will pay the price. Patients
will still show up in emergency rooms but only after manageable
conditions have become catastrophic, driving the cost of care
through the roof for everyone no matter their insurance status.
Listen, this is not theoretical. In safety net hospitals
across Illinois, frontline providers have warned me directly:
The Republicans' Big Beautiful Bill--or what I call the Large
Lousy Law--includes Medicaid and ACA cuts that will drive up
costs, slash essential services, and put struggling communities
into healthcare deserts.
At Loretto Hospital in the Austin neighborhood of Chicago,
83 percent of patients rely on Medicaid. In the face of
Republican cuts, hospital officials told me they may have to
close programs to ensure they do not have to fully shutter the
hospital.
In Benton, Illinois, which is in southern Illinois, I
visited Franklin Hospital where a fifth of the hospital's
budget comes from Medicaid reimbursements. Republican Medicaid
cuts will require them to provide care ``on a smaller scale''
so they can continue serving their rural community.
On top of that, leadership at Franklin Hospital told me
that if the Medicaid cuts are significant enough, they would
have to reduce staffing and reevaluate the services they can
provide, and this will affect the entire rural economy.
Republican healthcare cuts are going to close essential
hospitals, and this is a map of 11 hospitals in Illinois that
are set to shutter.
It is going to hurt everyone because it does not matter
what healthcare status you belong to, health insurance status
you belong to, if you use any of these hospitals and if they
close, you will be negatively impacted.
And so, that is why we need to be concerned about this
expiration of tax credits at the end of the year, but also the
implementation of the Large Lousy Law, because it will lead to
a crisis in healthcare that is eminently preventable today.
If we can just marshal our energies and collective
resources, we can pass an extension of the ACA tax credits and
prevent what would otherwise be a catastrophic situation for
millions of Americans.
Thank you, and I yield back.
Mr. Burlison. Thank you, Chairman Grothman, Ranking Member
Frost, and Ranking Member Krishnamoorthi.
I am pleased to welcome our expert panel of witnesses.
First, we have Brian Whorley, who is the Chief Executive
Officer of Paytient Technologies, Inc.
Next to him, we have Dr. Darius Lakdawalla, Quintiles Chair
in Pharmaceutical Development and Regulatory Innovation and
Chief Scientific Officer, Schaeffer Center for Health Policy
and Economics at the University of Southern California.
Next, we have Dr. Ziad Obermeyer, who is with Blue Cross of
California, Distinguished Associate Professor, Health Policy
and Management, at the University of California-Berkeley.
And next we have Mr. Chris Jacobs, who is the Founder of
the Juniper Research Group.
And finally, we have Ms. Sophia Tripoli, Senior Director of
Health Policy at Families USA.
Thank you to each and every one of you for being here
today. I am looking forward to your testimony.
Pursuant to Committee Rule 9(g), the witnesses will please
stand and raise their right hand.
Do you solemnly swear or affirm that the testimony that you
are about to give is the truth, the whole truth, and nothing
but the truth, so help you God?
Let the record show that the witnesses answered in the
affirmative.
Thank you, and you may take your seats.
We appreciate you being here.
And let me remind the witnesses that we have read your
written statements, and they will appear in full in the hearing
record. So, please limit your comments to 5 minutes.
The light system is pretty self-evident. Green is go,
yellow is wrap it up, and red is stop.
I now recognize Brian Whorley for his opening statement.
STATEMENT OF MR. BRIAN WHORLEY
CHIEF EXECUTIVE OFFICER, PAYTIENT TECHNOLOGIES, INC.
Mr. Whorley. Thank you. My name is Brian Whorley. I am the
CEO and founder of Paytient.
I founded Paytient because I believe the most powerful way
to remake the healthcare market and lower the prices we pay is
by increasing and returning purchasing power to the one
stakeholder in the system most sensitive to and capable of
discerning value, and that is the patient.
Our goal is to improve the ability of employers and
patients to simply purchase and pay for care. Ideally, paying
not just transparent but transactable cash prices directly to
providers whenever possible. We do that with help from pioneers
like HealthEquity and Mark Cuban Cost Plus Drugs today.
Today, we serve 6,000 employers who want the capital
efficiency of lower-cost health plans while ensuring that the
96 percent of their employees who never reach their out-of-
pocket maximum have an easier way to pay for care.
We do not do this work alone. We are grateful for partners
such as Elevance, Blue Cross Blue Shield of Arkansas, Cigna,
Centene, Gravie, Sidecar Health, Humana, and many others who
have been investing with us for years to improve the
affordability of the out-of-pocket experience for ACA,
governmental, and employer health plan members and providers.
I am proud to say that Paytient also provides the software
that powers the Medicare Prescription Payment Plan for nearly
22 million Medicaid beneficiaries.
The Medicare Prescription Payment Plan is a bipartisan
healthcare payment innovation that gives 54 million seniors the
option for their insurer to pay their out-of-pocket costs up
front at the pharmacy counter.
Seniors receive a statement at month's end to review for
accuracy and then pay in full, like most do, or simply smooth
their payment plan over the plan year to better fit their
household budget.
This innovation gives 54 million American seniors financial
security and the ability to personalize payment in a way that
works for their budget. It is a pragmatic approach to make
healthcare more accessible and affordable and recognizes the
ability to pay a $600 out-of-pocket expense is not the same for
every senior.
Importantly, this concept of cost smoothing, it improves
affordability without removing responsibility.
This bipartisan idea is catalyzing change in the employer
insurance market where brokers, employers, and insurers are
realizing that health plans that include cost smoothing create
the ability to have lower-cost health plans coupled with better
financial experiences for patients and providers.
The market is moving toward these hybrid healthcare plans
that have the efficiency of simply paying cash in full or over
time for low-cost routine care, coupled with the security and
peace of mind of insurance coverage and payment rails for rare
care.
Please consider four suggestions to expand the use of this
existing in-market technology to immediately improve healthcare
affordability.
One, ensure seniors are automatically protected from
unaffordable out-of-pocket costs by auto-enrolling them in the
Medicare Prescription Payment Plan.
Every insurer in the country has successfully launched and
operationalized M3P. Seniors like the financial protection,
convenience, and ability to review their monthly statements for
accuracy before they send in a check and pay for care. Plans
can and should automatically enroll seniors in 2027 in M3P
instead of laboriously requiring sick seniors to call, opt in,
and potentially delay care.
Two, encourage insurers to expand payments to include
medical costs. Why should seniors only be able to smooth their
pharmacy claims over time? Why not their larger, more costly,
and unpredictable medical expenses?
Second, expand payment smoothing into ACA and employer
plans, providing real relief to 180 million people today. To
help this innovation, uncompensated care from payment smoothing
should be clearly characterized as the equivalent to a medical
loss encountered below the line.
Three, allow seniors to access the benefit in real time.
Seniors should be able to opt in in real time when they need
help the most, when they are standing in a moment of
uncertainty at a pharmacy counter, instead of waiting 24 hours
and making a return trip to the pharmacy--or not.
The technology exists to allow seniors to opt in in real
time or near time, allowing them to simply get their meds when
they need to.
And last, return the economic power to the people by
allowing employees to receive and control more of their own
healthcare dollars. Give employers and employees the voluntary
option to receive the full cash value of what their employer
would have spent on their health plan into a Health Savings
Account (HSA) or a Roth version of an HSA that they could use
to invest in their health, purchase insurance, or simply and
directly pay transparent, transactable cash prices directly to
providers.
Thank you for the opportunity to share my testimony.
Mr. Burlison. Thank you, Mr. Whorley.
I now recognize Dr. Lakdawalla for his opening statement.
STATEMENT OF DR. DARIUS LAKDAWALLA
QUINTILES CHAIR IN PHARMACEUTICAL DEVELOPMENT
AND REGULATORY INNOVATION AND CHIEF SCIENTIFIC
OFFICER, SCHAEFFER CENTER FOR HEALTH POLICY
AND ECONOMICS, UNIVERSITY OF SOUTHERN CALIFORNIA
Dr. Lakdawalla. Chairman Burlison, Chairman Grothman,
Ranking Member Frost, Ranking Member Krishnamoorthi, and
honorable Members of the Subcommittees, thank you for the
opportunity to testify today about accelerating medical
innovation through regulatory reform. The opinions I offer
today are my own and do not represent the views of USC or the
Schaeffer Center.
In 1965, the world's first beta-blocker drug, propranolol,
was readily available to patients in Europe. Unfortunately,
American patients would have to wait 11 years to fully benefit
from this revolutionary treatment for cardiovascular disease.
We now know that delay was deadly. Clinical trials show
propranolol reduced stroke risk by 25 percent and cut heart
attack mortality by nearly 30 percent.
Later, USC Schaeffer research discovered this delay hurt
the least-educated households the most because they lacked the
means for the complex diet and exercise regimens that serve as
the key alternative treatment option.
Propranolol was not an isolated case. From 1972 to 1987,
new drugs were twice as likely to launch overseas first.
Then, in response to growing calls for timelier approvals
driven by the AIDS crisis, the FDA pioneered a series of
reforms, including the fast-track approval of HIV drug AZT in
1987.
Thanks to these and other forward-thinking regulatory
reforms, America is now the preferred launch market for
breakthrough medicines.
What is needed today is the next generation of forward-
thinking regulatory reforms that would encourage critical
innovation and improve the health of American patients.
First, Medicare's Coverage With Evidence Development
program needs urgent reform. Despite its name, CED limits both
coverage and evidence development.
USC Schaeffer analysis reveals how it creates stark
disparities. CED-qualified hospitals are half as likely to
treat patients that reside in rural areas. Similarly, they
treat fewer low-income, subsidy-enrolled patients and fewer
patients residing in socioeconomically disadvantaged
neighborhoods.
Not only do these kinds of constraints reduce equitable
access, but they also undermine a key goal of CED: to generate
evidence on a nationally representative sample of clinically
eligible patients.
Several steps could move CED in the right direction:
developing a clear definition of Centers for Medicare &
Medicaid Services (CMS)' ``reasonable and necessary'' standard,
limiting coverage constraints only to those circumstances where
clinical risks matter to patients, and providing transparent
milestones that would end CED restrictions.
Second, the current approach to Medicare Advantage risk
adjustment weakens or sometimes even eliminates incentives for
long-term prevention.
For instance, academic research shows that including
pneumonia in risk adjustment coincided with reductions in the
influenza vaccinations that help prevent pneumonia. That is
because risk adjustment insulates insurers from the cost of
long-term illness and eliminates their financial rewards from
preventing such illness.
On the provider side, alternative payment models also
encourage short-term thinking by limiting shared savings from
prevention to just 12-month horizons.
Treatment and prevention of obesity is a good example of
long-term thinking. Our research proves investing in obesity
treatments for the Medicare population generates at least a 13
percent annual rate of return--greater than the stock market.
This recent Medicare coverage expansion for obesity
treatments can help unlock this value, especially if coupled
with a framework that encourages broader preventive
investments.
As USC Schaeffer research has suggested, CMS could allow
multiyear enrollment in MA plans with premiums fixed over the
enrollment period and set to reflect average growth in cost.
Lengthening the payback period would align insurers'
incentives with the health of beneficiaries, especially because
beneficiaries tend to stay with the same MA plan for about six
years.
Third, we must tackle healthcare's pricing opacity. USC
Schaeffer research demonstrates that opaque pricing systems
profit from complexity.
Imagine grocery shopping where price tags are removed, and
you receive one aggregated bill at checkout. You would have no
idea if milk costs $5 or $50. That is American healthcare
today.
The economic logic is clear: when buyers cannot see prices,
sellers exploit that blindness.
In healthcare, aggregated payments and complex billing hide
true costs. This is not just inefficient. It is a transfer of
wealth from American families to healthcare intermediaries who
profit from confusion.
American patients deserve a healthcare system that delivers
breakthrough innovations efficiently, equitably, and
transparently. These reforms can deliver that system but only
if we act decisively.
Thank you.
Mr. Burlison. Thank you.
I now recognize Dr. Obermeyer for his opening statement.
STATEMENT OF DR. ZIAD OBERMEYER
BLUE CROSS OF CALIFORNIA DISTINGUISHED
ASSOCIATE PROFESSOR, HEALTH POLICY AND
MANAGEMENT, UNIVERSITY OF CALIFORNIA-BERKELEY
Dr. Obermeyer. Thank you for this invitation to testify. I
am a physician and a researcher at Berkeley where my focus is
on artificial intelligence applied to health. I am also the
Cofounder of a company called Dandelion and a nonprofit called
Nightingale Open Science, both of which are dedicated to
accelerating the development of health AI.
Every time a new technology comes around somebody says this
time is different, but when it comes to healthcare costs, new
technology always seems to increase them. That is because the
technology is expensive, but also because the more choices we
have of technology, the harder it is to make good decisions,
and that leads to waste and poor quality.
So, I am going to tell you that artificial intelligence is
different, and you should be suspicious, but let me try to
convince you.
The reason is because AI is a tool for making better
decisions, and that is how it can give us a rare two-for-one
opportunity to reduce the cost of care and improve the quality
at the same time.
Let me give you an example. Every year 300,000 Americans
drop dead suddenly because of cardiac arrhythmias. As an
emergency doctor, I have seen too many of those patients, and I
would guess some of you in this room also know somebody.
What makes these deaths so tragic is that we have a cure. A
defibrillator implanted into the heart could save those lives,
but doctors have trouble deciding which patients should get a
defibrillator, and that means a lot of people die without a
defibrillator.
But it means something else, too. Two-thirds of the
defibrillators that doctors actually put in never fire, never
deliver a lifesaving shock, because the patients we thought
were at high risk are not at high risk and never go on to
develop those arrhythmias. That is a $50,000 procedure with
real risks, but in this case zero benefit.
My colleagues and I have built an AI system to help solve
that problem. It looks at a patient's electrocardiogram and
estimates their risk of sudden cardiac death, and our early
testing shows it does so far more accurately than what doctors
are currently using to decide.
We are already starting to test that system, working with
an incredible team at Providence St. Patrick Hospital in
Missoula, Montana, and rural hospitals around there to get
defibrillators to people who need them and spare the hearts and
the pocketbooks of those who do not.
If saving lives and cutting wasteful spending sounds good
to you, there are a few ways that the Federal Government can
help.
First, data access.
When I started this work, it was so difficult to get the
data that we needed here in the United States that I ended up
doing this research in Sweden. That process took ten years, but
it was still faster than doing it here despite European data
regulations.
That is a real problem for patients who do not know that
they are at high risk and a problem if we want the United
States to lead in health AI.
The major culprit here is the many layers of permissions
and approvals required to touch health data. Most of that
burdensome paperwork does not actually keep patients or their
data safe, and it also opens the door to ideological bias. The
paperwork is used to decide which questions get asked and which
do not, instead of assuring that any question can be asked in a
safe and ethical way.
Concretely, Federal agencies that hold health data should
set clear targets for delivering it. Health and Human Services
(HHS) should also green-light modern technical tools for rapid
de-identification of AI-ready data, like images and notes, and
ONC should prevent vendors from locking up those data with fees
and delays.
None of this means compromising privacy or safety. In fact,
just the opposite. Adopting modern data management methods can
increase speed and access while improving safeguards.
Second, FDA evaluation.
Today we regulate artificial intelligence under statutes
written in 1938, which treat it as a medical device, but AI is
quite different from a thermometer.
AI makes predictions about measurable outcomes, and that
gives us a simple and rigorous way to evaluate it: does AI
predict what it is supposed to predict in populations that look
like all of America?
The FDA should put that question at the center of its
approach to AI and build or partner on data infrastructure for
a rigorous, independent evaluation. That transparency is
essential for rapid progress and for catching problems like
algorithmic racial bias, as I have shown in my prior work.
Third, CMS should pay for AI that does good.
The private sector is currently underinvesting in AI tools
because of deep uncertainty about what payers will pay. CMS has
the power to shape that, and the new Advancing Chronic Care
with Effective, Scalable Solutions (ACCESS) model is a
promising new step in that direction, but CMS should go further
by creating payment codes for AI tools that are shown to
improve outcomes, reduce cost, and detect fraud and abuse.
As my 5 minutes draw to a close, three Americans have
experienced sudden cardiac death since I started to speak. They
might still be alive if my data access had taken nine years
instead of ten. Speed is important for patients. It is also
important for the fiscal health of the United States--and it is
important because we are in a race.
We have a head start in that race with great data, world
class universities, and purchasing power, and if we make it
easier to use data, regulate well, and pay for high-value
tools, we can reduce cost, save lives, and secure American
leadership in AI.
Mr. Burlison. On the dot, Dr. Obermeyer.
I now recognize Mr. Jacobs for his opening statement.
STATEMENT OF MR. CHRIS JACOBS
FOUNDER, JUNIPER RESEARCH GROUP
Mr. Jacobs. Thank you, Chairmen Burlison and Grothman,
Ranking Members Frost and Krishnamoorthi, and Members of the
Subcommittee.
Good morning. Thank you for inviting me to testify. My
entire written statement is before you, so I will not repeat
it, but instead make three main points regarding healthcare
costs and insurance coverage.
First, Obamacare has not met its stated objectives. The law
singularly failed to achieve candidate Obama's 2008 promise
that his healthcare plan would, ``bring premiums down by $2,500
for the typical family.''
Individual health insurance premiums more than doubled in
the law's first four years of full implementation and continue
to rise faster than premiums for employer-sponsored coverage.
Meanwhile, the law encourages insurers to avoid the sickest
patients, often harming those it most intended to help.
Second, despite what some may believe, there is a
surprising amount of bipartisan consensus about the law's
failure to control healthcare costs.
Two years ago, Senator Elizabeth Warren coauthored a letter
noting that Obamacare's medical loss ratio provisions have
encouraged insurance companies to acquire other businesses,
like pharmaceutical benefit managers, and to overcharge
patients through PBMs to shift profits from their insurance
business, where Obamacare caps their profits, to pharmacies and
other businesses without such restrictions.
Indeed, healthcare has only become more consolidated since
Obamacare's passage with hospitals and health insurers buying
up physician practices--and each other--to gain additional
market clout.
Provisions like the medical loss ratio (MLR) have led
progressives to write analyses discussing, ``How Obamacare
Created Big Medicine.''
A separate academic study concluded that the 340B
prescription drug discount program, which Obamacare greatly
expanded, raised exchange benchmark premiums by 1.8 percent in
2024, resulting in $2.2 billion in additional Federal spending
on insurance subsidies.
Third, as to the enhanced premium subsidies expiring on
December 31, this Republican Congress should follow the example
Democrats set regarding the child tax credit in 2021 and allow
this temporary COVID-era policy to expire.
The myriad studies regarding fraud on the exchanges,
including last week's Government Accountability Office report,
demonstrate why Washington should not spend 350 billion
taxpayer dollars, plus interest, to mask flaws in a law that
has made healthcare less affordable.
Thus far, during open enrollment, 400,000 more people have
signed up for exchange plans than did so at the same time last
year, notwithstanding the impending expiration of the enhanced
subsidies.
These preliminary data suggest that the worst-case scenario
cited by enhanced subsidy supporters have not come to pass,
reinforcing why Congress should let them expire.
Instead, lawmakers should pursue alternative policies that
will enhance insurance portability, realign incentives, and
promote price and quality transparency.
Thank you very much for the opportunity to testify, and I
look forward to your questions.
Mr. Burlison. Thank you, Mr. Jacobs.
I now recognize Ms. Tripoli for her opening statement.
STATEMENT OF MS. SOPHIA TRIPOLI (MINORITY WITNESS)
SENIOR DIRECTOR OF HEALTH POLICY, FAMILIES USA
Ms. Tripoli. Chairs Comer, Grothman, and Burlison, Ranking
Members Garcia, Frost, and Krishnamoorthi, and Members of the
Committee, thank you for the opportunity to testify today.
On behalf of Families USA, a leading national nonpartisan
voice for healthcare consumers, I want to thank you for this
critical discussion.
The United States is in a full-on healthcare affordability
crisis, and our Nation's families are breaking under the weight
of it.
We all see it. Parents who cannot afford the treatment
their kids were prescribed. Families delaying care because
their deductibles wipe out their savings. Workers who
technically have insurance but cannot actually afford to use
it. Employers who want to offer good insurance but are being
crushed by rising premiums. And Federal and State lawmakers in
gridlock over how to balance budgets and which services to
prioritize.
Today's focus on technology is important given the rapid
advancements in technology over the last century, which has
revolutionized healthcare delivery on everything from reducing
medical errors to strengthening diagnostics and treatment
protocols to streamlining eligibility and enrollment
determinations for coverage.
But it is important to note that while technology is a
critical tool that can drive innovation and increase efficiency
with appropriate patient protections in place, it is not a
replacement for comprehensive, affordable health insurance.
People without insurance are in no position to benefit from
healthcare technology, and technology itself does not address
the core drivers of unaffordable care.
The trajectory of healthcare costs in this country is
unsustainable for consumers, for the public sector, and for the
private sector alike. But this is not caused by people using
too much care or because immigrant families need healthcare.
Our affordability crisis is caused by corporate health
systems, whether it is big insurance giants, drug companies, or
corporate hospital chains charging excessive prices that have
absolutely no relationship to healthcare quality or outcomes
and with no accountability from lawmakers.
These excessive prices generate record profits for these
corporate health systems all on the backs of the millions of
Americans who cannot afford to buy groceries or pay rent
because of rising healthcare costs.
But instead of taking on the corporate price gouging at the
core of our Nation's affordability crisis, this Congress cut a
trillion dollars from the very programs built to provide a
safety net and ensure access to affordable care and has so far
failed to extend the enhanced premium tax credits that keep
coverage affordable for 22 million Americans.
Poll after poll confirms that heading into 2026, voters
want lawmakers to address healthcare costs above all other
priorities--jobs and unemployment, immigration, crime, and the
budget deficit. Ninety-one percent of the American people, from
conservative Republicans to progressive Democrats, are begging
this Congress and the President to lower their healthcare
costs, not strip away their only lifelines to more affordable
coverage.
Voters want Congress to rein in the corporate profiteering
making healthcare unaffordable, and your decisions have real-
life consequences for everyday Americans.
For people like Tony Gonzales in Pennsylvania who is
fighting cancer and can only afford the treatment keeping him
alive because of premium tax credits.
And Brick Williams, a small business owner in Utah who
needs regular infusions to stay alive, costing $150,000 a year
without insurance. Enhanced premium tax credits are the only
reason he can afford his lifesaving care.
And Cassandra Nelson in rural Georgia who cares for her
daughter with Type 1 diabetes and seizures and has been crushed
by the weight of medical debt and the dread of wondering
whether she can afford the care her child needs.
These families and millions more across the country are
doing everything right and playing by the rules, yet stand to
lose everything in a system that is rigged against ordinary
Americans and built to fuel corporate greed.
As challenging as this moment appears in our Nation's
history, there is good news. We already know the solutions that
will lower healthcare costs and hold corporate health systems
accountable for charging the excessive prices driving our
Nation's healthcare affordability crisis.
The solutions are to immediately pass a clean extension of
the enhanced premium tax credits; to enact site-neutral
payments to stop big hospital systems from charging Medicare
more for the same procedure if it is performed at a hospital
instead of a doctor's office; to allow Medicare to negotiate
prices on more drugs and closing legal loopholes that allow
drug companies to block lower-cost drugs from coming into the
market; to stop Medicare Advantage companies from exaggerating
patients' health risks just to get paid more; and to scrutinize
the growth of private equity and the monopoly power of big
corporate healthcare chains that drive up healthcare prices for
all of us.
These policy solutions are wildly popular and garner almost
no opposition from voters across political parties. The
American people are fed up with the broken healthcare system,
and they are frustrated with politicians who choose to play
politics with their health and financial security instead of
delivering meaningful reforms.
We appreciate today's discussion on technology and its role
in potentially reducing cost and the opportunity to draw
attention to the healthcare affordability crisis.
Congress has the power to advance policies that will lower
healthcare costs and hold corporate health systems accountable
for our Nation's affordability crisis. We urge you to take
action.
I thank the Committee for your time, and I look forward to
answering your questions.
Mr. Burlison. I am very thankful for the opportunity to co-
chair this Subcommittee hearing along with my colleague,
Chairman Grothman, and I want to thank again the witnesses for
being here today on this important issue.
Unnecessary government regulation is an obstacle to
developing innovation in healthcare technology. This is
technology that will not only--I am sorry. I am supposed to
recognize myself for 5 minutes. I am yielding to myself for 5
minutes.
Unnecessary government regulation is an obstacle to
developing innovation in healthcare technology, something that
I worked in for almost 22 years. This is technology that will,
if left alone, lower costs but improve patient outcomes and
save lives.
But bureaucrats often step in the way, just like the Biden
Administration did when they attempted to force a one-size-
fits-all approach to the healthcare sector while failing to
consider what is happening at the local level.
While I served in the Missouri Legislature, I introduced a
plan that was called the Health Care Compact, trying to wrestle
that one-size-fits-all authority back to the states. And I am
pleased today that I have another fellow Missourian who is
thinking outside of the box, Mr. Whorley, on how to address the
healthcare costs for patients.
Mr. Whorley, what have you found to be the greatest
obstacle in your business to develop this new kind of way in
which people can pay?
Mr. Whorley. Every single day we are motivated by one
single goal, and that is to help people better access and
afford care.
We employ a team of incredibly talented people to make the
unsure, uncertain moment that is facing Americans all across
the country something of the past. And so, we want to give
people the confidence, the ability, and the dignity to easily
and effortlessly access and pay for care.
I think our biggest barrier to that is just the inertia of
the status quo, and moving that uphill requires the best
efforts from all of us.
Mr. Burlison. Would you say that the status quo is propped
up by the regulations that this town has created that really
kind of--that stop innovation like yourself, like what your
company has provided?
Mr. Whorley. I think the degree, to the extent that we
can--the best regulation is probably no regulate--the ability
for us to innovate and have degrees of freedom to respond to
the market and respond to the customers and partners that we
serve, that is what we are attuned to.
Mr. Burlison. And how would you say that your business
under the previous administration, now that you have had ten
months under this administration, have you recognized any kind
of change?
Mr. Whorley. 2025 has been a transformational watershed
year in that we have enabled nearly 20 million people to more
easily access and afford care. We are providing people with the
peace of mind and certainty and ensuring that that unsure,
uncertain moment that they are standing in a pharmacy is
something of the past. We are giving them the ability to take
care of themselves and their loved ones, and that is with the
launch of the bipartisan Medicare Prescription Payment Plan.
Mr. Burlison. Thank you.
Mr. Jacobs, how has the Affordable Care Act caused
healthcare to actually be unaffordable?
Mr. Jacobs. Thank you, Mr. Chairman.
It has really encouraged consolidation within the
healthcare sector. I talked in both my prepared testimony and
my written comments about how the medical loss ratio encourages
consolidations, that we essentially have healthcare oligopolies
now, that it encouraged insurers to buy pharmaceutical benefit
managers and other forms of businesses where they could offload
and shift their profits.
Mr. Burlison. Vertical integration.
Mr. Jacobs. Correct.
Mr. Burlison. Forced vertical integration.
Mr. Jacobs. And there is also vertical integration within
the hospital sector.
Ms. Tripoli's statement noted the significant amount of
hospital mergers that have taken place over the years and I
believe said that 40 percent of those occurred between 2010 and
2015.
Well, there was a law Congress passed in 2010. It is called
Obamacare. And to say that that did not have an impact, I think
it very clearly did have an impact.
Whether it is accountable care organizations, that entities
wanted to purchase physician practices, they wanted to purchase
each other to get additional market clout to negotiate more
power to negotiate with the insurers across the table from
them.
Mr. Burlison. Yes.
Dr. Obermeyer, you addressed that in order to move forward
you need access to data. One of the previous bills that was
passed before Obamacare was passed was actually to create these
health information exchanges, but, in my opinion, having worked
in that space, it has been an abysmal failure. It does not
work. It does not benefit patients. The data does not go from
doctor to doctor.
And then to hear that you say that it is not even
accessible for research, you know, anonymized, this is
something that we have to get our hands on, particularly if AI
is going to be moving forward. And I worry about where we are
with that.
How do we address that in a way in which we can still
properly secure somebody's health information?
Dr. Obermeyer. We are used to thinking about a tradeoff
between how easy it is to access the data and how safe it is. I
think that tradeoff is largely a product of using old
technology and old data management systems.
The most sensitive data in the world are kept on modern
systems that let people access it when they need it and keep
out others. I think, paired with a strict approach to law
enforcement, we can have the best of both worlds.
Mr. Burlison. Thank you.
I now recognize Mr. Frost for his line of questions.
Mr. Frost. Thank you so much, Mr. Chairman.
And thank you so much to our witnesses for being here.
Mr. Whorley, you were chatting a little bit about in the
last question line that you guys were able to help 20 million
people in 2025. How does that compare to other years with your
company?
Mr. Whorley. It is an enormous step up.
So, on January 1, 2025, it was the launch of the Medicare
Prescription Payment Plan. That gave nearly 54 million American
seniors with Part D coverage the ability to more efficiently
and effectively get care, to smooth their costs over time.
Mr. Frost. Yes. Thank you.
So, how would you describe the demand for your services?
Mr. Whorley. It is increasing.
Mr. Foster. Okay.
If more people have to opt in for worse healthcare plans,
higher deductibles, different things like that, would that also
increase demand?
Mr. Whorley. The demand has increased as insurers and
employers are recognizing that they can have both a lower-cost
health plan and compassionately ensure people can access care.
It is a programmatic approach that enables people to get the
care they need and pay for that care at the time of service.
Mr. Frost. No, I appreciate it.
And so, your company, essentially you make money helping
people to pay their healthcare bills in a more smooth way.
If there are more people who cannot pay for their
healthcare bills at once, will there be more demand for
software like yours?
Mr. Whorley. Yes.
Mr. Foster. And if healthcare becomes more affordable, if
we had, let us say, my North Star, single payer healthcare,
something like that, people that need to enter payment plans
for healthcare, there probably would not be as much of a demand
for the services, right?
Mr. Whorley. No. I think that the North Star and what
affordability is, affordability is an emotion, it is the
ability to take care of yourself. And what we do is we give
people the financial ability to manage whatever financial
responsibility----
Mr. Foster. Whatever the costs are, yes.
Mr. Whorley [continuing]. May well be.
Mr. Frost. No, I appreciate that. And I am not trying to
paint you as a bad person or anything. It is to make a point.
Because you are a serial entrepreneur who finds a problem,
right, and figures out a solution, and that is your
prerogative, right?
And we do have a problem. Healthcare is too damn expensive.
The cost of healthcare is too high. And I would submit that
part of the reason why there is such a bigger demand for your
services than ever before is because the cost of healthcare is
going up and up and up.
And that is why I am confused on why my Republican
colleagues have you as a witness here on this panel about
affordable healthcare. Not a dig at you personally but because
I think it shows--because there is so much more demand for
companies like yours, it shows that we are failing in Congress,
and whatever policies are being done right now are not helping
people afford their healthcare and bring down the cost of
healthcare.
We are here to talk about bringing down the cost of
healthcare, and if you cannot afford to get it, right, when you
receive that bill, it means you cannot afford it.
My dad was always strict with money. He always told me, if
you could not afford it when you got it, you cannot afford it
at all. If you have to buy now, pay later, you cannot afford
it. And that is part of the issue.
And I think it makes sense why more people need services
like yours, is because healthcare is too damn expensive, and
President Trump and congressional Republicans are making it
worse.
And that is why I come back to this extension of the
Affordable Care Act tax subsidies. We have just five weeks
until the ACA open enrollment ends, and in five weeks 189,000
people in my district alone are going to see their healthcare
skyrocket.
I cannot tell you how many of my own friends and family
have called me saying: ``What the hell? What are you guys going
to do about this? I mean, I used to pay this much and now I am
going to be paying this much. I cannot afford it.''
And this is going to happen to 25 million of our people.
That's why I keep coming back to this, because there's
something right in front of us that has to do with
affordability.
I want to talk about the subject of technology and AI in
healthcare. I think this is an important hearing to have. But
right in front of us we have a cliff that is coming up, and if
we do not do our job, more people are not going to be able to
afford their healthcare and more people are going to have to do
buy now, pay later plans to be able to pay to stay healthy in
the richest country on the face of the Earth, which I think is
disgusting and I think is a failure of our government.
Ms. Tripoli, if the subsidies expire how will this impact
how often people go to the doctor, how sick they get, and how
much debt they have to take on?
Ms. Tripoli. Thank you for the question.
If the subsidies expire, we will see premiums more than
double. For some families, we will see increases of 300
percent. For older couples, we will see--just above the 400
percent of poverty--we will see them paying about a quarter of
their income on healthcare costs.
We know in the midst of an affordability crisis that it is
unaffordable. It will force people to forego care, drop out of
coverage if they have to. And, of course, when folks drop out
of coverage, we know that they do not go to the doctor, they
delay, or they end up in the emergency room, which is the most
expensive care setting to get healthcare.
Mr. Frost. And, Ms. Tripoli, if we have folks who say, you
know what, I disagree with a lot of different parts of our
healthcare system--look, I know we have a broken healthcare
system, but we have this clock ticking, this countdown timer in
front of us.
Would you advise us to let the countdown end and have
healthcare go up for so many working families while we try to
figure out a plan that no one really has right now, or would
you say that we deal with what is right in front of us and then
have those conversations.
Ms. Tripoli. Time is of the essence. The first thing you do
when somebody is bleeding is you stop the bleed. The tax
credits need to be passed with a clean extension immediately.
It is a lifeline for 22, 24 million Americans. And then let us
come back to the table and talk about how we address the root
drivers on drugs, on hospitals, and others to bring down the
underlying cost of care.
Mr. Frost. That is why we have to pass the extensions for
the Affordable Care Act, because our people are suffering right
now. The cost of everything is too damn high. And if we do not
do our job, 25 million Americans are going to see their
healthcare go up anywhere from 50 to 300 percent. Then let us
get back to the table and figure out what we do to fix this
broken healthcare system.
I yield back.
Mr. Burlison. Thank you.
I have a document to submit for the record from the Juniper
Research Group titled ``No, Obamacare Premiums Are NOT Doubling
in 2026'' that I am submitting for the record.
Without objection.
And with that, I recognize----
Mr. Frost. Mr. Chairman, I request unanimous consent of a
UC. I have a UC, a document.
Mr. Burlison. You are recognized.
Mr. Frost. Mr. Chairman, I ask unanimous consent to enter
to the record fact sheets from Keep Americans Covered that
shows that my Republican colleagues on this Committee represent
738,000 people who depend on the Affordable Care Act tax
credits.
Mr. Burlison. Without objection.
I now recognize----
Mr. Grothman. I would like to--can I submit for the
record----
Mr. Burlison. Yes. Mr. Grothman.
Mr. Grothman [continuing]. A CMS fact sheet with regard to
historical national health expenditure data and an AMA fact
sheet on trends for healthcare spending?
Mr. Burlison. Without objection.
Mr. Grothman. Thank you very much.
Mr. Burlison. I now recognize Chairman Grothman.
Mr. Grothman. Okay. First of all, I am grateful for an
opportunity to have this hearing with my Co-Chair, and I want
to thank the witnesses one more time for coming over here.
A few weeks ago, the Health Care and Financial Services
Subcommittee held a hearing where we heard from the Trump
Administration about the youth healthcare crisis. Not only are
our children facing chronic diseases at rates never seen
before, but the healthcare system seems to only get more
expensive without any noticeable improvement in outcomes.
Recent data published by the Trump Administration and
confirmed by several other independent sources indicate that
one-third of healthcare costs are wasteful and do not improve
patient health.
We will start with Mr. Jacobs.
Why are one-third of healthcare costs wasteful and fail to
improve patient health? Do you believe that is true?
Mr. Jacobs. I certainly think there is a great amount of
waste in the healthcare system. Unfortunately, we, as I
mentioned in my testimony, we do not have correctly aligned
incentives. The traditional example is the all-you-can-eat
buffet. Everybody does a good job of spending everyone else's
money in healthcare.
Obviously, there are circumstances. You are not going to
try to shop for care when you are in an ambulance on the way to
the hospital or anything else like that.
But we do need to realign incentives at the margins to show
where people can be smarter shoppers of healthcare, but first
that requires price and quality transparency. I have had
personal difficulties myself on numerous occasions finding out
what the heck things cost.
Mr. Grothman. I will give you guys another question, and
anybody can jump in here.
Utilization rates vary from doctor to doctor and state for
state. Does anybody want to comment on that or have any
information on examples of overutilization which would indicate
that more is being spent than has to be spent?
Dr. Lakdawalla. Well, Chairman Grothman, one issue is that
if you look at that variation from state to state, it tends to
be greater in Medicare than it tends to be in the commercial
insurance market, and I think that indicates that when there is
oversight in terms of what is valuable care, it helps to
mitigate overuse.
Examples of overuse, a prominent one is what is known as
defensive medicine. So, it is testing that is undertaken
because of malpractice risk. It probably adds, our research
suggests, around ten percent to medical spending. So, that is
one important source as well.
Mr. Grothman. Okay. And that varies from state to state?
Dr. Lakdawalla. It does, yes.
Mr. Grothman. Can you give examples of a high state and a
low state or just a shot at a specific example of dramatically
higher costs in one state than another state?
Dr. Lakdawalla. Typically, the states that award higher
jury awards in malpractice cases tend to have more defensive
medicine.
Mr. Grothman. Okay.
I think we can all agree we have a problem when one-third
of healthcare spending, according to some people, goes to
waste. Can you explain why that is such a problem and how it
affects the healthcare market?
Mr. Whorley, I guess we will start with you.
Mr. Whorley. Yes. Healthcare costs are a combination of the
volume of care we seek and the prices we pay.
Enabling people to pay the price and enabling more and more
cash prices and direct prices, for there to be a single price
for all versus a single payer for all, enabling people to
actually know what the price is ahead of time, the real price
that intermediaries or AI cannot reprice, that is important to
enable patients and employers, purchasers of care, to get the
signal: Is it the right price?
I think it is important that in terms of volume, where
there is overconsumption, there is also underconsumption in the
market as people are unable to pay for care. That is why nearly
30 percent of ACA markets have built solutions like Paytient
into ACA plans to ensure that people are able to get care when
it happens because healthcare is a necessity.
Mr. Grothman. Okay. What I will do is go down the line
starting with Dr. Lakdawalla.
How have you personally experienced rising healthcare costs
in your individual field or from the perspective that you are
in right now, and specifically what would you like to see
Congress do to rein in those costs?
Dr. Lakdawalla. I would like to see attention paid to
measuring the value of different healthcare procedures, drugs,
devices, and the like, and ensuring that we are not continually
investing in low-value care, which is happening.
For example, most Americans say they do not want to die.
They do not want to spend their last days of life in a
hospital. Yet a majority of individuals end up there. That is
wasteful care because it is not aligned with what patients
value and their families value.
Mr. Grothman. In other words, people are--well, go ahead. I
am running out of time. So, we will go down the line.
Dr. Obermeyer. I will just tell you one fact from my own
experience as a physician.
I have ordered a lot of wasteful tests, for example, in the
ER, tests for heart attack that expose patients to risk and
costs and come back negative. At the same time, heart attack is
one of the most common reasons that doctors get sued, because
we miss it.
And so, even though, of course, there is a lot of
contribution from incentives, fear of malpractice, the core of
the problem, at least from my perspective, is that it is really
hard to make decisions about who needs care. And I think that
is why I am so optimistic that artificial intelligence can help
us make better decisions. And, thus, reduce the cost of care,
but also improve the quality by taking some of those costs and
giving it back to patients who need the care.
Mr. Grothman. Mr. Jacobs?
Mr. Jacobs. As an exchange customer here in D.C. who is
facing a premium increase starting next month, I certainly
understand the cost because I have to pay all of those out of
pocket. I am self-employed. So, I do not have an employer to
subsidize.
I actually agree with Ms. Tripoli. I think site neutral
payments--and there is a good amount of bipartisan agreement on
this--is a good policy that Congress should be enacting. I just
recently went to a specialist for a second opinion on an
orthopedic issue, and I ended up paying twice what I normally
pay at my usual specialist, primarily because the second
opinion was affiliated with the hospital, and it is a physician
office visit, but it is billed through a different service. It
is billed as an outpatient clinic visit, and so I pay twice as
much.
We should not be inviting these kind of disparities, and
that encourages more physician practices to merge with
hospitals because they can charge more.
Mr. Grothman. I am going to break the rules and ask the
final question to Ms. Tripoli, the Democrat witness.
Ms. Tripoli. Well, I actually agree that the underlying
incentives--the payment incentives of the healthcare system are
misaligned. All the incentives are to get bigger and bigger and
to charge more volume of high-price services rather than making
sure that people are getting the high-value care that they need
to get healthy and stay healthy.
And so, I do think that there is a longer term conversation
about how do we structurally realign incentives with the health
and financial security of the American people, but I will tell
you that it is very hard to have that conversation when you
have got 22 to 24 million people right now who need the
enhanced premium tax credits extended. And so that is the
lifeline they need today.
And, then, I encourage Congress to have a conversation
about how to realign payment incentives in the healthcare
system. Absolutely.
Mr. Grothman [continuing]. Thank you.
Mr. Burlison. Thank you.
I now recognize Ranking Member Krishnamoorthi for his
opening statement--or for his line of questions.
Mr. Krishnamoorthi. I can do that, too. Thank you. Thank
you, Mr. Chair, and thank you to the witnesses. Your answers
have been very thoughtful and really appreciate your
participation.
Ms. Tripoli, I want to share the story of the family of a
woman named Krystle from central Illinois, which is where I am
from. She is in contact with my office, and here is a picture
of her three children, who have some medical--very complex
medical issues.
After growing up on Medicaid, Krystle finally secured a job
with employer health coverage. But the plan's cost for her
three medically complex children were so high, the employer-
sponsored coverage was effectively unusable. With the ACA's
enhanced premium tax credits, however, she can, instead, buy
coverage for her three children at $800 a month on the
exchange.
Now, if we let those tax credits expire, her premiums will
nearly double to $1,400 a month, trapping her in a coverage
gap.
Ms. Tripoli, the Medicaid coverage gap, which Krystle is
experiencing, affects millions of Americans who earn too much
to qualify for Medicaid but not enough to afford private health
insurance coverage. That is why the tax credits were created in
the first place, to enable people to afford, like Mr. Jacobs
and others, the health insurance that is available on the
exchanges.
And, Mr. Jacobs, I am also on the exchange like yourself.
So, here is my question to you, Ms. Tripoli. Unfortunately,
Krystle does not have an extra $600 a month to pay for her
insurance. So, to get out of the coverage gap, she would be
forced to leave her job so that her kids can qualify for
Medicaid coverage because the only alternative to risking their
health is basically going without coverage, which is a choice
no parent should ever have to face.
Ms. Tripoli, Krystle's story is not unique, right?
Ms. Tripoli. It is absolutely not unique. And you are
highlighting the exact reason why we need the enhanced premium
tax credits extended immediately, not to mention the challenges
that were imposed from H.R. 1 in terms of Medicaid work
reporting requirements and how difficult it will be for people
to meet--who are working, but to meet those requirements under
the new Federal rules.
And so, there is absolutely a need for families like
Krystle--and there are millions of families like hers across
the country--to get the relief they need right now, and that is
through extending the enhanced tax credits.
Mr. Krishnamoorthi. Folks, as we approach the holiday
season, please keep in mind families like Krystle's. I mean, we
have to extend these. Even if we are going to negotiate future
iterations of these tax credits, let us do the humane and right
thing, which is to extend these tax credits for some period of
time while we negotiate the rest of the ACA.
Mr. Jacobs, you recently wrote this article entitled, ``The
Middle Class Cannot Keep Up With Persistent Inflation
Forever,'' right?
Mr. Jacobs. Yes.
Mr. Krishnamoorthi. It was from December 1st of--this
month, right?
Mr. Jacobs. That is correct.
Mr. Krishnamoorthi. You wrote, ``American households feel
stuck in an ever-growing vice by prices rising faster than
their incomes can keep up,'' correct?
Mr. Jacobs. Yes.
Mr. Krishnamoorthi. Donald Trump recently claimed that the
affordability crisis is a ``hoax.''
You wrote in this article--and I agree with you--``Trying
to claim inflation does not exist will not cut it,'' correct?
Mr. Jacobs. True.
Mr. Krishnamoorthi. You also wrote, ``I see it every week
when I go to the grocery store. I consider myself luckier than
most, but the weekly shop still feels painful.'' That is what
you wrote, right?
Mr. Jacobs. Yes.
Mr. Krishnamoorthi. You also, in part, blame Trump's tariff
policy for high prices on things like bananas and coffee,
writing, ``It seems foolhardy ever to have imposed levies on
items that our climate will not allow us to grow in sufficient
quantities domestically, but, at a minimum, ending the tariffs
will provide a bit of relief.'' That is what you wrote, right?
Mr. Jacobs. That is correct.
Mr. Krishnamoorthi. Despite controlling the House, the
Senate, and the White House, Republicans have done nothing to
bring down high prices. On the contrary, your article title
could not be truer, Mr. Jacobs. The middle class cannot keep up
with persistent inflation forever. President Trump's tariffs
only make them worse.
Now, let me turn to my final topic, and that is AI. Ms.
Tripoli, AI has become increasingly prevalent in healthcare
settings. In fact, a recent study from Rand, Brown University,
and Harvard found that one in eight adolescents and young
adults use AI chat bots for mental health advice.
You do not dispute they found that, right?
Ms. Tripoli. No, I do not.
Mr. Krishnamoorthi. Time Magazine recently reported that,
when asked about self-harm, some of these bots have offered
guidance on how to, ``safely cut oneself or what to include in
a suicide note.''
Ms. Tripoli, again, this is what Time and other news
outlets have been reporting, right?
Ms. Tripoli. Correct.
Mr. Krishnamoorthi. My home state of Illinois has banned AI
chat bots from offering any kind of psychotherapy for anyone.
Other states have similarly instituted different guardrails for
AI.
Unfortunately, there is a move currently from the White
House to preempt all state laws with a national law preventing
this type of legislation that Illinois and other states have
instituted or enacted to put guardrails on AI.
Dr. Obermeyer, your testimony today--and I read--we read
through your testimony--does not endorse preemption and, in
fact, does not even mention it, correct?
Dr. Obermeyer. Correct.
Mr. Krishnamoorthi. Mr. Chair, the Majority's own witness
did not mention preemption in its testimony because it is
premature. There are great things happening in red and blue
states alike that are protecting our children.
We have one of the few chances right now to come together
and say ``no'' to a really hasty national preemption plan that
the White House is initiating, and I hope we do not lose that
opportunity to work together.
Thank you, and I yield back.
Mr. Burlison. Thank you. Chairman Grothman.
Mr. Grothman. I would like to submit another document for
the record called ``How much does that MRI cost?'' put together
by Unleash Prosperity. I want you all to look at it. It shows
similar procedures varying from $300 to $7500 depending upon
the provider.
Mr. Burlison. Thank you. Without objection.
I now recognize Mr. McGuire for his 5 minutes of questions.
Mr. McGuire. Thank you, Mr. Chairman, and thank you to the
witnesses for being here today.
The tariffs--by the way, I heard mention of tariffs.
Tariffs are working. For the first time in a decade, we have a
surplus. That means our government has been spending more per
month than we bring in per month.
If you ran your house like that, you would be on the
street. And, if you ran your business like that, you would be
out of business.
Now, the tariffs are important. I mean, American steel is
back, bigger contracts than they have ever had. You cannot do
anything without steel. And gas prices are coming down because
we are drilling more today than we ever have.
In fact, in Roanoke, Virginia, this weekend someone sent me
a screenshot at the pump, under a dollar--under $2 gas. I think
it is $2.35 today, but still, we have not seen prices like that
in five years.
Now, we got into a big mess over the last four years, and
we have only been here about 11 months or so. It takes a while
to turn the ship. But the One Big Beautiful Bill puts jet fuel
on our economy, and, hopefully, by the spring you are going to
see this.
The problem is the government does not do a whole lot
right. If they built you a car, it would cost a million
dollars, and, you probably would be a year or two late in
getting it, and it would fall apart. That is why we need free
market competition.
You have heard about COPN, a certificate of public need. It
is like there is a monopoly and in control from those in
charge. And, if we had free market competition, it would drive
down prices.
I think the first calculator was this big. It was $5,000.
But, with innovation and free market competition, it got better
and smaller and better and smaller, and now you can buy a
calculator for $1 at the dollar store.
We have not been allowing competition because the
government is involved. And, again, I can talk about the U.S.
Post Office. I talked--in my district, we have health clinics,
41 I think, and several hospitals. And I asked them, ``You have
to deliver medications every week to people that rely on these
medications for life or death. Do you use the U.S. Postal
Service?'' They said, ``No. We use FedEx and UPS.'' And I said,
``How reliable are they?'' They said, ``100 percent reliable.''
And I said, ``How reliable is the post office run by the
government?'' And they said, ``Not reliable at all. We cannot
use it.'' I said, ``Well, give me a worst-case example.'' And
they said, ``Well, we mailed some medicine in 2013, and we got
it returned to us in 2023.''
And so, I think the big problem with the cost overrun is--
Obamacare, for example, they call it the Affordable Care Act. I
would call it the un-Affordable Care Act because it took away
the free market competition, and it totally benefited the
insurance companies, and they can charge whatever they want.
When talking with hospitals about COPN, a doctor would say
to me, ``Hey, I want to start--in rural Virginia, far away from
a hospital, I want to start an MRI clinic because I can do it
for $500 apiece, or you can go to a hospital and spend $1,500,
$2,000 apiece.'' Sounds like common sense, right?
But then the folks at the hospital said, ``Well, the
problem is there are a lot of things we do at the hospital that
do not make money. So, then, at the hospital, we charge a whole
lot, to make up for the programs that do not make money.'' So,
again, it is nonsensical. It is a mess. And we need free-market
competition.
We also need a preventative healthcare system. When you buy
a car, it tells you, ``At 2,000 miles, do this; at 5,000 miles,
do this; at 15,000 miles, do this.'' We seem to have a system
where you put Band-Aids on it and wish and hope and wing it and
modify it. And it does not work that way in the business world.
You would be out of business if you did not have some sense.
For example, would you rather find a tumor when it is this
small or when it is this big, and if you had a system of
checkups and things like that?
But, be that as it may, we are where we are. And so, I
guess what I would ask is--we do not have a lot of time. Let us
get some yes-and-noes.
Do you agree that a productive rather than reactive system
would help us shrink government? That is just a yes or no. I do
not have time.
Mr. Whorley. Yes.
Dr. Lakdawalla. Yes.
Dr. Obermeyer. Yes, and AI can help.
Mr. Jacobs. Sure. Yes.
Mr. McGuire. I totally agree with that.
And, for all the witnesses, do you agree that more
competition in medical tech will lead to better outcomes for
patients? Yes or no, because I do not have time.
Mr. Whorley. Yes.
Dr. Lakdawalla. Yes.
Dr. Obermeyer. Yes.
Mr. Jacobs. Yes.
Ms. Tripoli. More competition is always good, yes.
Mr. McGuire. I like it. I like it. All right.
I am also hopeful that data-driven approach to healthcare
can help speed up FDA approval processes and reduce our
reliance on countries like China for tests, and it is terrible
that some of our most important medicines are made in China.
Do you guys agree with this, yes or no?
Mr. Whorley. Yes.
Dr. Lakdawalla. Probably.
Dr. Obermeyer. Yes.
Mr. Jacobs. Yes, I think we should be near-shoring those
kind of critical materials, yes.
Mr. McGuire. You cannot exercise your way out of bad
nutrition.
So, do you guys agree that a preventative healthcare system
that they say the positive effects of fitness on the brain and
mental health by having proper nutrition and exercise is very
important? Do you agree with this?
Mr. Whorley. Americans being in better health is better for
America.
Dr. Lakdawalla. Prevention is underused and needs more use.
Dr. Obermeyer. Yes.
Mr. Jacobs. Yes.
Ms. Tripoli. Your best prevention is having access to
affordable care.
Mr. McGuire. Well, thank you. I ran out of time. I yield
back.
Mr. Burlison. Thank you.
Ranking Member Frost?
Mr. Frost. Mr. Chairman, I have a unanimous consent request
to enter into the record.
The Hill article, states ``Medicaid cuts will harm rural
Republican communities most.''
Mr. Burlison. Without objection.
I now recognize Ms. Randall for her line of questions.
Ms. Randall. Thank you so much, Mr. Chair, and thank you to
our witnesses for being here today.
I love a robust conversation about how we can improve our
healthcare system. I do not think any of us on either side
would say that the system that we have is perfect and is
working exactly as it was intended to.
I do, however, have real concerns about saying, ``It is not
working. So, we should not reinstate these affordable care tax
credits so that more people can lose their healthcare so that
the system is even more broken, and then we have to decide how
to fix it.'' I do not think that is the way to meet the
healthcare needs of the American people. It is not the way that
they are asking us to meet their healthcare needs, and it is, I
think, frankly, dangerous for our country.
We have, as my colleagues have said, a ticking clock on
these ACA tax credits. We were so quick to act when, you know,
billionaire and big corporation tax credits were set to expire.
Congress was called back into session from vacation to make
them permanent.
I do not understand why we would not act immediately for
the benefit of the American people who are struggling with
affordability and are struggling with the healthcare system.
That said, you know, I think, even the original drafters of
the Affordable Care Act, including President Obama himself,
would argue that the ACA was not the be-all, end-all dream of,
you know, healthcare for people in this country. They did not
have the votes for public option.
So, yes, giving money to the insurance companies is a large
part of what the ACA is able to do because that is how people
are guaranteed healthcare.
Before the ACA--I do not know how everyone's memories are
on this. Folks may not have been super-engaged. Before the ACA,
women who had been pregnant could be denied healthcare
coverage. Folks who had other preexisting conditions, any
healthcare needs could be denied healthcare coverage. We had
very high uninsured rates and high rates of people unable to
access healthcare.
There are lots of ways to make sure that we solve that
problem. The Affordable Care Act was the bill that had the
votes to pass at the time. It has been a while. We can revisit
rebuilding a healthcare system like Mr. Frost has said, like
single-payer, that meets the needs of the people, lowers costs,
and ensures a more healthy future for all of us.
There are lots of different approaches that countries
around the world have taken that have been explored. In the
United States, I, as a member of the legislature in Washington
State, worked on establishing Washington State's universal
healthcare commission, some of the strongest universal
healthcare policy to be passed by any state in the last ten
years.
We know that we need improvements, but we also know that
the free market is not the solution for healthcare. An
unchecked free market means that, you know, folks who do not
have coverage, who do not have the ability to afford care just
will not get it. They will die often.
Yes, you cannot shop around in the ambulance, but there are
ways that we can provide more transparency into healthcare
costs, like Washington and many other states who have created
an all-payer claims data base that collects and publishes data
so that you can look up how much it costs on average to get a
mammogram and how much those mammograms cost at different
facilities near you.
But the problem for most people, especially in rural
communities, including many in my own district, many in the
districts of my Republican colleagues, are that there are not
that many healthcare facilities available and accessible. And
those that are, are at risk of closing because of the dramatic
cuts from the big, ugly bill to Medicaid.
Rural healthcare was at risk before we passed H.R. 1, and
now it is hanging by a thread. What does it matter if you could
shop around if your nearest two hospitals are two and three
hours away from you.
I also think we need to make space for technology, and I
know that is what we are here to do today, to talk about how
innovation and technology can help lower costs for families.
But I hear a lot from my neighbors on Medicare who are worried
about unchecked technology and AI impacting their ability to
access care.
Dr. Obermeyer, I am concerned about the Wasteful and
Inappropriate Service Reduction (WISeR) Model and what that
unchecked AI implementation will do to folks' abilities to
access care. That is why I am a cosponsor of the SMARTER Care
Act, a measure to ban the WISeR Model from Medicare claims.
Do you believe that AI systems need independent oversight
to ensure patients are not denied medically necessary care?
Dr. Obermeyer. Absolutely.
Ms. Randall. Thank you.
I would like to request unanimous consent to enter into the
record a letter from a retired physician in my district, how
WISeR will enable companies to profit from pain.
Mr. Burlison. Without objection.
Ms. Randall. Thank you.
Mr. Burlison. And your time has expired.
Ms. Randall. I know my time is up. I will just wrap up by
saying, I agree we have to fight consolidation. I agree we have
to fight to take some of the costs out of the healthcare
system. I agree that more people need access to better
healthcare.
And what we know is that vertical integration and
consolidation of our healthcare systems does not lower costs
for patients at all. It may lower costs for the provider
groups. It may lower costs for the shareholders, but it does
not lower costs for patients. Thank you.
Mr. Burlison. Thank you.
I now recognize the Governor--I am sorry--the gentleman
from Florida, Mr. Donalds.
Mr. Donalds. Thank you, Chairman. I appreciate your
sentiment.
Before I get into questions, I think it is important to
acknowledge what was just said. I want to start with some of
the positives I just heard.
The truth is that, yes, more competition in healthcare is
going to be critical to deliver affordable care to consumers,
and that is something I think which is a very bipartisan
statement. I think both sides of the aisle can agree on that.
I think one of the things that was also just acknowledged
is that the entire purpose of the Affordable Care Act was not
the Affordable Care Act. It was to take the United States
toward single-payer healthcare. That was the design 15 years
ago.
So, the American people need to understand, the reason why
costs are rising in healthcare and in health insurance is by
design, by congressional Democrats at the time, and by then-
President Barack Obama. They did want a public option. They
wanted to put a public option in the Affordable Care Act that
was going to be lower cost than what their own regulatory
framework would allow in the private markets.
The only reason they did not get the public option is
because they did not have the votes. A guy named Scott Brown
won a Senate election in Massachusetts--I know that sounds
crazy today, but he did--and it stopped them from actually
pushing forward with the public option, which, by the way, its
entire design was to move America toward single-payer
healthcare.
The arc of history in healthcare needs to be clear on this
point: single-payer healthcare does not work. It never will
because, to the point of my colleague from the other side of
the aisle, single-payer is the very definition of vertical
integration of the healthcare system, which will not lead to
lower costs for the American people. But I digress.
Mr. Jacobs, you referenced that a single Social Security
number was linked to over 26,000 days of subsidized healthcare
coverage across more than 125 insurance policies in 2023.
What mechanisms can be put in place to detect and prevent
this level of exploitation of taxpayer funds, and what
underlying vulnerabilities contributed to this abuse?
Mr. Jacobs. Yes, Mr. Donalds, that is correct. And the
Government Accountability Office report that was released last
week was just one of many data points suggesting that there are
significant amounts of improper enrollment and potential fraud
on the exchanges.
I think some of it is driven by--there are certainly rogue
agents and brokers that have been acting in CMS both under the
Biden Administration and certainly under the Trump
Administration have acted to crack down on that. I think
eliminating zero premium plans, I think, is a matter of good
policy that I think, regardless, we should be asking everyone
to pay at least a little bit of something toward their health
insurance every----
Mr. Donalds. Not to cut you off, but I want to acknowledge
something that you just said.
In your opinion, do zero premium plans lead to fraud and
abuse?
Mr. Jacobs. I think without a doubt. The system responds to
incentives. And we have only had zero premium plans for the
past few years under the enhanced subsidy regime, and we have
seen that the amount--the concerns about improper enrollments,
whether it is CBO or CMS with the data regarding zero claim
enrollees in exchange coverage, all of them have been pointing
to increased incidents of improper enrollments and fraud.
Mr. Donalds. Okay. Thank you for that.
Dr. Obermeyer, if artificial intelligence becomes
significantly integrated into medical practice, what impacts
should we expect on the healthcare workforce?
Dr. Obermeyer. I think what we have learned from the
history of automation and technology adoption is that it does
not necessarily eliminate jobs. It actually changes the nature
of those jobs.
So, doctors will start to need to interact with these tools
and learn from them, and I think they will start to augment the
capabilities of especially nurses, community health workers,
and others who can now have access to cutting-edge technology
applied to the data from patients to help them make better
decisions.
Mr. Donalds. Real quick, a quick follow-up to that. Do you
think that the Affordable Care Act's regulatory framework
allows for this type of internal innovation in the healthcare
system?
Dr. Obermeyer. I do not know about the ACA specifically. I
think right now there are not very strong incentives for a lot
of health systems to adopt this AI technology. I think the
ACCESS program that was recently announced from CMS is a good
start in that direction by incentivizing preventive care
augmented by technology.
But I think that government programs can do more by, for
example, creating payment codes for AI technology that drives
lower costs, higher value care, and even detects the kinds of
fraud, waste, and abuse that you mentioned earlier.
Mr. Donalds. Well, look, I am all for efficiency. One of
the things I do have a concern about is I hear that, yes, AI is
being used in some respects in healthcare, a lot of it for
upcoding as opposed to pushing for efficiencies. And I think
that is a major issue that we definitely have to get our heads
around, both here federally and at the state level.
Chairman, if I might indulge, I did want to ask a quick
question of Ms. Tripoli. I know--I was hearing your dialog with
one of my colleagues earlier about affordability. I recognize
everybody has a concern about it. Honest question.
Do you really think that a centralized healthcare system
will lead to efficiencies and lower costs for the American
people?
Ms. Tripoli. I think there are a lot of different models to
get to a universal system of coverage that make sure that every
person in the country has access to the affordable high-quality
healthcare and health that they deserve.
In any of those systems, you have to actually address the
incentives and the way the prices in the healthcare system are
set. And whether you are in the current system we have now or
some future system, the reality is that the biggest drivers of
our affordability crisis in this country on healthcare are the
massive consolidation from corporate health systems, from
insurance plans to drug companies to hospital chains.
And so, in any universal system of coverage, that issue has
to be addressed. And, of course, most immediately, if people
cannot afford care, then they cannot access care. And before us
right now, there is a decision about extending the enhanced
premium tax credits, and we urge the Congress to act on that.
Mr. Donalds. Well, Ms. Tripoli, we will have some agreement
on consolidation. I have serious concerns about that
consolidation as well.
I think if we are talking the universe one-size-fits-all
system, I mean, I have not seen one that has worked just about
anywhere in any industry that has ever existed on this planet,
but I know people will continue to try.
Sorry, Chair. I know I am over. I yield.
Mr. Burlison. Thank you.
I now recognize my colleague from Missouri, Mr. Bell, for
his 5 minutes.
Mr. Bell. Thank you, Mr. Chair, Ranking Member, and our
witnesses for being here today.
The purpose of today's hearing is to discuss how technology
can help reduce the future cost of healthcare, but I find this
topic very ironic because we cannot look forward to the future
of healthcare while ignoring the challenges that Americans are
facing now.
The reality is that there are over 24 million Americans
facing unaffordable healthcare with the pending expiration of
the ACA premium tax credits. In Missouri alone, premium tax
credits assist 95 percent of our marketplace enrollees.
And so, I heard a few comments that have me over here
scratching my head. Mr. Jacobs, you said that the ACA has not--
did not make it--has not met its stated objectives, and costs
continue to rise faster, and there is a failure to control
healthcare costs.
You remember saying all that, right?
Mr. Jacobs. Yes.
Mr. Bell. So, I want to use an analogy again. So, would
everyone agree that Social Security overall is a good thing?
Any objections to that? Okay.
So, when Social Security was created in the 1930s, most
women were excluded; intermittent workers were excluded; nearly
half the workforce population was excluded. And then it gets
really rich with Black folks. Two-thirds of African Americans
were excluded, 70 to 80 percent in certain regions of the--of
African Americans were excluded.
But, over the years, Social Security was improved. And I
would say mostly by Democrats, but there was some bipartisan
efforts there throughout the years to improve it.
So, we would--I think it is safe to say that there was a
point in time Social Security was not necessarily effective and
a good thing and supporting folks, a lot of folks who needed
it, and it got better because folks worked at it.
So, it is befuddling to me when, when we talk about the
ACA, when Republicans talk about how bad the ACA is, first, it
is the best thing we have got going right now. Yes, it could be
improved, so let us improve it.
And so, let us talk about the history. I am a data person.
So, in 2010, Republicans unanimously opposed the Affordable
Care Act--we all know that--and did not offer any alternatives,
right? No alternatives. Just opposed it, every single
Republican.
2011, as soon as Republicans retook control of the House,
they voted to repeal the ACA. Remember, the whole repeal and
replace? We never got the replace idea, but that is a different
subject. Every Republican voted to repeal it.
2012, Republicans unsuccessfully challenged the ACA in
court. Now, was there any court filings that the Republicans
championed to improve the ACA? No. Just to repeal it.
I got a lot here, too. I am going to try to get it in here.
In 2013, Republicans refused to fund the government without
delaying or repealing the ACA. They did not say: ``Hey, we got
some ways to improve it. We just want to repeal it.''
2015, Republicans passed a bill repealing the ACA that was
voted--that was vetoed by President Obama. No--no help--no
ways, suggestions to improve it.
In 2017, days after taking office, President Trump canceled
ACA enrollment outreach advertising during open enrollment.
Ms. Tripoli, does that help get the word out and help get
coverage for folks?
Ms. Tripoli. No.
Mr. Bell. In 2017, Republicans tried and failed to repeal
the ACA again. In 2017, Republicans passed Donald Trump's tax
plan gutting the ACA's individual coverage mandate. Notice,
there was no legislation to improve it, make it better for
Americans.
In 2017, the first Trump Administration cut enrollment
outreach funding by 90 percent. They did not do anything to
improve the ACA.
So, when we are three weeks away from the end of the year
in the middle of open enrollment season, and I am still
waiting, we are all still waiting for a vote to protect the
American people, so, again, I got to ask, where is it? Where is
this vote? Where is the help? Where is this plan? Where is the
action to back up the promises and talking points?
And so--where is the evidence that you all truly care about
the affordable access to healthcare for the American people?
Because every single thing that we see is just to repeal what
is--what has done the best to control costs for Americans. Yes,
it could be better, but Republicans got to work with us.
Americans are screaming for relief with healthcare costs.
And I appreciate some of the things that you are doing,
particularly Mr. Whorley in Missouri, but these are only layers
of things that we need to improve healthcare costs.
But we have to address these issues head on, and it is
going to take Democrats and Republicans actually working
together and stop playing politics and actually get in the room
and do it. If you do not want to call it Obamacare, great, we
will call it something else. We can call it the Obama-Trump
plan. I do not care. Let us just do what we can to work for the
American people and bring the costs down.
And right now Republicans for the last--since this act was
implemented, have not given us one single plan to improve it or
to--to help Americans address these issues.
Thank you. And I yield back.
Mr. Burlison. Thank you.
I now recognize the gentleman from Texas, Mr. Gill, for 5
minutes.
Mr. Gill. Thank you, Mr. Chairman. Thank you for holding
this hearing, and thank you to the witnesses for taking the
time to be here. We certainly really appreciate it.
I appreciate my colleague on the other side of the aisle
and their sincerity and their desire to fix our healthcare
system and make it better. I would suggest that Social Security
and our healthcare system are not comparable or perhaps even
analogous.
Our healthcare system is $5 trillion. It is about 18
percent of our GDP. And Social Security does not have the same
bloated cost structure that is inherent in a single-payer
healthcare system, which our colleagues on the other side of
the aisle have been ultimately proposing. And I think we need
to think a little bit more deeply about ways that we can bring
those costs down rather than bringing in, I think, incomparable
and unanalogous other government programs.
But, with that said, I do think that there is a lot of
bipartisanship in healthcare, and I think that there are a lot
of things that we would agree on.
Ms. Tripoli, thank you for being here, and thank you for
your testimony. I believe in your testimony you urge
policymakers to get the root causes of high and irrational
prices in our healthcare system. Is that correct?
Ms. Tripoli. Yes.
Mr. Gill. And you would agree that healthcare consolidation
is one of the main drivers of high prices for patients?
Ms. Tripoli. Yes.
Mr. Gill. I certainly agree.
And you also mentioned price disclosure, that hospitals
should disclose the rates that they charge openly in dollars
and cents, I believe, were your words. Is that right?
Ms. Tripoli. Absolutely, yes.
Mr. Gill. I certainly agree. You also mentioned site
neutrality, that we ought to prohibit health systems from
charging Medicare more for the same procedure if it is done in
a hospital versus a doctor's office. Is that right?
Ms. Tripoli. Yes.
Mr. Gill. Those are, I think, all things that we can agree
on, which is really, really nice to hear. So, I appreciate
that.
Mr. Jacobs, I want to ask you about Obamacare. Obamacare
was sold to the American people as a program that would drive
down premiums. I think the number that was thrown out by
President Obama at the time was $2,500.
Has that promise come to fruition?
Mr. Jacobs. No, it has not, Congressman. And premiums on
individual health insurance policies on the marketplaces and
the exchange has more than doubled in the law's first four
years. And that is primarily from the regulatory mandates that
the law imposed. And prices have continued--premiums have
continued to increase substantially, and they continue to
increase substantially more so on the exchanges than for
employer-sponsored coverage.
Mr. Gill. So, you would say that Obamacare did not slow the
growth of premiums in any meaningful way?
Mr. Jacobs. I think, if anything, quite the contrary. I
mean, Senator Welch, I believe, last month admitted on the
Senate Floor that the law failed to reduce costs.
But, more than that, I think it has accelerated the cost
growth because of the consolidation that has come about in
terms of hospital mergers, insurers buying PBMs, et cetera, et
cetera.
Mr. Gill. And that is what I was getting to. Did Obamacare
address or fix any issues related to price transparency?
Mr. Jacobs. Ultimately, there have been regulatory efforts.
Some of the Trump Administration efforts were actually linked
to regulatory requirements in the law. But I think we can and
should do more, and I think we have also seen that hospitals
are not necessarily complying with that law either willingly or
easily.
Mr. Gill. Did Obamacare address or fix issues related to
pricing disclosure?
Mr. Jacobs. I think we need to do more is what I would say.
Mr. Gill. Got it. And it is your testimony as well, if I
heard you correctly, that Obamacare actually exacerbated
pricing issues related to healthcare consolidation?
Mr. Jacobs. That is correct. And we have seen that in many
areas.
For instance, the Congressional Budget Office recently
released a report on the 340B program and how the 340B program
encourages increasing Federal spending and consolidation.
Now, Obamacare did not create the program--the 340B
program, but it certainly dramatically expanded it and is one
of reasons why it continues to grow and continues to accelerate
health costs.
Mr. Gill. Got it. And, with the remaining 30 seconds, as
you know, there is a lot of debate right now about potentially
extending COVID-era enhanced premium tax credits.
In your opinion, would that lower overall healthcare costs,
or would it raise overall healthcare costs?
Mr. Jacobs. The subsidy regime is inherently inflationary
because, once an individual hits their income in terms of how
it is structured in the law, the percentage of income, every
marginal dollar of a premium increase gets paid by the Federal
Government.
So, insurers have no incentive to control costs because,
whether the premium goes up by one percent or 100 percent, the
Feds subsidize that. And so, it is an inherently inflationary
structure. We have seen the concerns about fraud.
I think those reasons, coupled with the fact that
enrollments have held study thus far in open enrollment, all
suggest that we should allow the enhanced subsidies to expire.
Mr. Gill. Got it. Thank you.
Mr. Burlison. Thank you.
I now recognize the gentlelady from California, Ms. Simon,
for 5 minutes.
Ms. Simon. Thank you all for coming today to be a part of
this conversation. I especially want to say hello to my
constituent from UC Berkeley, Dr. Obermeyer. Thank you so much
for being here.
And I know we are talking about the affordability of
healthcare and ACA credits, which I will expand on in my short
remarks.
But I want to say, I am a widow, and I lost my husband, who
left me parenting two girls by myself. And he was diagnosed
with a terminal cancer that was so rare, only about ten people
in the United States get this cancer each year. And, after five
years, despite the intervention and the treatment, they all
die.
Kevin had T-cell prolymphocytic leukemia. And, even with
insurance, flying across the country to find just a little bit
more time and getting into a clinical trial, it took all that
we had. And, post his passing, myself and my little girls were
left with a mountain of debt, a mountain of debt. I am so
thankful to our insurance providers because, without them, that
debt would have been in the millions, not just a million.
$27,000 a day for a bag of Campath that hung while he had
amino therapy every day for nine months before transplant. I
could not imagine--I could not imagine where we would be even
though we struggled without health insurance.
In January there will be families, tens of thousands of
them across the Nation--maybe in the hundreds of thousands--
they will see their rates, but triple. Many of them will have
no choice but to just bail out--we know that--and use emergency
room care.
The Democrats and Republicans, for whatever reason--maybe
we have not independently personally suffered enough in our own
families to figure out how to put politics aside and get it
right for families who are suffering, who are waiting on a call
for a clinical trial, families who are waiting for labs like
the CRISPR lab to develop just one more innovation that might
give dad or mom or that baby with TPN in her nose just a little
bit more time.
So, all has been said on this panel. But one of the things
that I think it is important for me personally and politically,
having talked to thousands of families as a cancer mom and as a
cancer widow, we cannot innovate fast enough.
You know, during the congressional Black Caucus
Foundation's annual legislative conference, I actually hosted a
panel with OpenAI and Akido Labs, and the Hidden Genius Project
and a brilliant scholar, Rashad Robinson, on how AI is
transforming medicine and innovation.
I am from the Bay Area, the home of AI, the home of biotech
innovation, and I am so proud to represent that sector. I am so
proud to represent that region.
We know that we can, in fact, democratize medicine. We can
democratize innovation. New technologies, including AI, present
exciting opportunities for patients, physicians, scientists,
and families.
We already know that AI is advancing lifesaving early
detection for cancer, Alzheimer's--right in Berkeley at the
CRISPR lab. We know we are this close. Doc, you know this--to
providing sickle cell patients with a new lease on life. This
close. Unfortunately, the Trump Administration took millions
from that lab, leaving folks waiting.
As someone, myself, who was born a preemie with a
congenital visual impairment, I know how important these
technologies are for disabled communities. I know how, as I
talked about before, important these technologies are for
clinicians, who, when my husband was diagnosed with T-PLL, they
were using--you all know who are physicians--they were using
up-to-date printouts, you know, up to date. Can you imagine in
ten years where we will be when physicians and pathologists
will have the technology to immediately access gazillions of
language models, again, to give patients and families more
days?
So, I have some questions. I do not have the time, but what
I am committed to doing here with you all in my district and
beyond and with Members of this Committee across the aisle is
engaging in a short-and long-term conversation that hopefully
involves action to get it right for the people who need us
most.
I want to thank you all for coming today. I cannot wait to
work with you all in my office a little bit more, hopefully a
lot of bit more, and to continue to be someone who yells from
the rooftops about what our people deserve and what, hopefully,
they will get.
And I will yield back. Thank you so much.
Mr. Burlison. Mr. Frost?
Mr. Frost. Mr. Chairman, I ask unanimous consent to enter
into the record a Commonwealth Fund report entitled ``Expiring
ACA Premium Tax Credits Could Lead to nearly 340,000 jobs lost
across the United States in 2026.''
Mr. Burlison. Without objection.
Mr. Frost. And one more. This is from the Center on Budget
and Policy Priorities, entitled ``By The Members, Harmful
Republican Megabill Will Take Away Healthcare Coverage Away
from Millions of People and Raise Families' Costs.''
Mr. Burlison. Without objection.
In closing, I want to say thank you again to our witnesses
today for your testimony.
And, with that, I will yield to Ranking Member Frost for
his closing remarks.
Mr. Frost. Thank you so much to our witnesses for being
here, and thank you so much to Chairs, plural, for having us
here today.
This conversation of healthcare affordability is incredibly
important, very personal to so many people on this panel. And
it is important that we look at what is right in front of us,
which is the expiration of the Affordable Care Act tax
subsidies.
Like I mentioned and I entered into the record earlier, my
Republican colleagues on this hearing represent 738,000 people
who depend on the Affordable Care Act tax credits.
In Missouri Seventh; that is 59,000 people. In Wisconsin
Sixth, that is 34,000 people. In Alabama Sixth, that is 56,000
people. In Arizona's Ninth, that is 44,000 people. In
Louisiana's Third, that is 44,000 people. In Texas 17th, that
is 76,000 people. In Florida's 19th, that is 149,000 people. In
Florida's 13th, that is 101,000 people. In Pennsylvania's 10th,
that is 25,000 people. In Virginia's Fifth, that is 36,000
people. In Colorado's Fourth, that is 24,000 people. And, in
Texas 26th, that is 90,000 people.
These are not just statistics and numbers. Behind every
number, there is a person who is at risk of having their
healthcare going up from anywhere from 50 to 300 percent. I
think this conversation is an important conversation we need to
have after we deal with the healthcare crisis right in front of
us.
Let us pass and extend these tax credits to make sure that
working-class people in this country do not see their
healthcare costs go up so much that so many of them will just
decide not to have health insurance, and then let us get to
fixing this broken healthcare system.
I yield back.
Mr. Burlison. Thank you. I now recognize myself for a
closing statement.
We heard from expert panel witnesses on how to make
healthcare more affordable for the American people. And
Americans want simple, affordable, transparent healthcare, but
our current system hides the prices. It blocks competition and
routes every decision through an unnecessary regulation and
bureaucracy. We must prioritize innovative technologies and
pathways forward to help lower these costs.
Today our witnesses spoke about their personal experience
navigating the healthcare market. They testified on how
misaligned structures in the current healthcare system are
keeping healthcare costs high because there are not incentives
to drive the costs down.
Artificial intelligence will eliminate unnecessary costs,
if allowed, and may allow providers to direct their efforts
fully toward making patients healthier. And the Trump
Administration is paving the way forward for entrepreneurs to
develop the best healthcare in the world while also promoting
consumer choice.
We need this innovation because the status quo is totally
broken. The American people are suffering from the un-
Affordable Care Act passed by the Democrats.
Since 2014, Obamacare has skyrocketed the costs of
healthcare and has not led to better patient health outcomes.
The one thing that we might be unanimous on in this country is
that Obamacare has failed in its goal of reducing healthcare
costs. In fact, it has made it worse.
We hear you, America. You are not getting simple,
affordable, and transparent healthcare right now. And that is
why, rather than have the hearing and just have conversations,
I am taking action. That is why I am introducing a bill called
the Make America Healthy Again (MAHA) Act that will put
consumers back in the driver's seat and allow for free market,
as intended, to spur competition and lower costs and give
people back their freedom and their choice.
The MAHA Act will allow consumers to shop on the price and
the quality of healthcare services. Unlike under Obamacare,
this will force providers to compete in the open market,
driving down costs and making those costs actually transparent.
Consumers will have access to tax-free health wallet that
patients can use as real money as opposed to coupons that are
controlled by an insurance carrier. This account will be
portable from job to job, giving workers their freedom back
instead of being locked into a job because of fear of losing
their health coverage.
This program will also make prices clear by encouraging
price posting and upfront costs, creating a true consumer-
focused market. The American healthcare system is facing a
nationwide shortage across all major category of providers, and
my plan would encourage the elimination of medical education
inflation and scope creep, expand and modernize residency
training, and eliminate arbitrary hospital caps on residency
slots, increasing the supply of doctors and medical
professionals.
The American people have spoken. They want more affordable
healthcare. Today's hearing lays the foundation for a more
affordable healthcare system in America by focusing on
innovative technology and new pathways forward.
The Democrats have failed. Obamacare has failed. The
American people and Republicans are ready to act. And this act,
my MAHA Act, will fix this broken system, lower healthcare
costs for Americans, and put American families back in the
driver's seat for their healthcare decisions.
And I now recognize Chairman Grothman for his closing
remarks.
Mr. Grothman. Thank you. Sorry, I had another hearing.
First of all, I would like to thank the chairman for
getting us together on this very informative hearing, and I
would like to thank all of you for coming from all the country,
four corners of this nation, to educate us on the higher cost
of healthcare.
I think we have seen consensus here today that there is
probably too much being spent on administration and that, in
some areas, there is overutilization driven by greed.
I want to thank our witnesses again. Americans want
transparency on where their money is going, and we have the
responsibility to deliver solutions and provide our citizens
with the best healthcare system.
We learned today that implementing the innovative
technology can provide a solution to tackle wasteful spending
and misaligned pay incentives. The application of technology
has the potential to address the large administrative cost
burden that many patients must pay that they do not have
knowledge of.
Many of us have experienced high cost within the healthcare
without receiving high-value care for ourselves and families.
One-third of healthcare spending in the United States goes to
waste, and we must act now to address this growing problem.
It is going to be tough because, of course, if we spend
less money in our healthcare system, somebody is going to be
getting no check or a smaller check. So, the special interests
will be out looking to protect the status quo.
But I think the Republican Conference is up to it, and I
think we will stand up to those special interests and find a
way to reduce the out-of-control costs, which is such a burden
on your average American patient.
Thank you again for letting me in the room.
Mr. Burlison. Thank you, Chairman Grothman.
Thank you, Ranking Member Frost.
And, with that, without objection, all Members have 5
legislative days within which to submit materials and
additional written questions for the witnesses, which will be
forwarded to the witnesses.
And, if there is no further business, without objection,
the Committee stands adjourned.
[Whereupon, at 11:58 a.m., the Subcommittee was adjourned.]
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