UnitedHealth Group CEO Stephen Hemsley told two House panels that rising hospital prices, health system consolidation, specialty service charges and prescription drug costs are the primary forces driving U.S. health care spending higher, not insurer margins. He noted that premium rates reflect both care utilization and the prices charged for that care, and that when hospitals and large health systems increase their negotiated rates, overall coverage costs inevitably rise. Hemsley emphasized that UnitedHealth negotiated nearly $300 billion in provider discounts last year and eliminated $35 billion through fraud and waste reduction initiatives, underscoring the insurer’s role in cost restraint even as he acknowledged that more must be done across the system.

In prepared remarks to the House Energy and Commerce Subcommittee on Health, Hemsley pledged that UnitedHealth will voluntarily eliminate and rebate all profits on Affordable Care Act exchange coverage for the current plan year. The company, which serves roughly one million ACA enrollees across 32 states, has not yet detailed the mechanics of the rebate program or its financial impact, but Bloomberg analysts estimate that rebating 100 percent of individual market profits could amount to several hundred million dollars. The move is aimed at deflecting criticism that the nation’s largest health insurer is unduly profiting from taxpayer-subsidized coverage.

To address cash-flow challenges at rural hospitals, UnitedHealth launched a six-month Rural Payment Acceleration Pilot that aims to cut Medicare Advantage claim collection times in half—from under 30 days to fewer than 15 days. The initial phase will include independent facilities in Oklahoma, Idaho, Minnesota and Missouri, providing immediate liquidity to hospitals that lack the negotiating leverage of larger systems. Hemsley said the pilot could be expanded to additional states and could serve as a model for improving access to care in underserved communities.

Beyond internal initiatives, Hemsley urged Congress to enact several targeted policy reforms: site-neutral payment rules to eliminate arbitrary price differentials between hospital outpatient departments and physician offices; patent reform to curb excessive prescription drug costs; limits on direct-to-consumer drug advertising; and standardization of broker compensation in ACA plans, mirroring the Medicare Advantage model. He argued that these measures, combined with broader adoption of value-based care models, are essential to delivering better outcomes at lower costs and ensuring sustainable coverage for all Americans.