House Republicans used a Ways and Means Committee hearing Tuesday to argue that hospitals and health systems are a major driver of rising health care costs, pressing four executives on profits, pay, and consolidation.
“Our communities are better off with hospitals in them, but large health systems have taken advantage of that reality,” Chairman Jason Smith, R-Mo., said. “Simply put, hospitals are charging an insane amount for care.”
Smith said hospital prices have risen 300% in just over two decades and argued that limited competition has contributed to higher prices.
Smith also raised site-neutral payment policy, which would lower Medicare outpatient payments for hospital services to the same level as a doctor’s office. Earlier site-neutral proposals had bipartisan support, but hospitals said they would lose billions of dollars and opposed them.
The hearing included the chief executives of HCA Healthcare, the country’s largest for-profit health system; CommonSpirit Health, the largest Catholic hospital chain; New York-Presbyterian, one of the wealthiest health systems; and ECU Health, a large rural system in North Carolina.
It was the latest in a series of Republican-led hearings on health care prices. Earlier this year, lawmakers questioned insurance and pharmaceutical executives, who also blamed hospitals for rising costs.
Rep. Greg Murphy, R-N.C., asked HCA Healthcare’s chief executive “why we should allow for-profit systems to exist.” Murphy said he recognized rising costs and uncompensated care, but said executive compensation had also increased.
“I don’t want to sound like a communist; I’m not. I’m a capitalist at heart,” Murphy said. “But if we now have institutions that put profits above patients … we have to rethink this model.”
Democrats said the hearing was an effort to shift attention from Medicaid cuts included in last year’s One Big Beautiful Bill. Rep. Richard Neal of Massachusetts, the panel’s top Democrat, said Republicans were trying to “distract from their record of failure” and argued the law had strained hospitals.
Hospital executives said higher reimbursement rates were needed to cover overhead costs, and they pointed to low insurer payments and inflation as key pressures.
“When it comes to fixing the system, the only thing you all agree on, really, is that some other people, other issues — that’s the increase,” Smith said.