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Lawmakers and witnesses press reforms to lower ACA-era premiums, debate incentives and PBM market power
Summary
Members and witnesses discussed proposals to curb rising premiums under the Affordable Care Act, including a bipartisan short-term bill, incentive-based insurance designs (including multi-year plans modeled on Switzerland), and concerns about market concentration among pharmacy benefit managers.
Speaker 1, Unidentified Speaker, opened by tying rising costs to the Affordable Care Act and to insurer behavior: "since the Affordable Care Act took effect in 2014, the insurance company profits have skyrocketed by more than 230% while insurers deny as many as 1 out of 3 claims," Speaker 1 said, adding that premiums have increased "96% since 2014." He said he had introduced a bipartisan bill with "Bridal Fitzpatrick and a couple of Democrats" intended to prevent steep premium hikes for the roughly "24,000,000 Americans who rely on the Affordable Care Act."
Why it matters: lawmakers framed the conversation as a mix of short-term fixes for subsidies and longer-term market reforms. Speaker 1 emphasized both protecting current enrollees who depend on ACA coverage and curbing what he described as predatory behavior by insurers, brokers and…
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