Modernizing American Health Care: Creating Healthy Options and Better Incentives

Health Care Costs and Drug PricingHouse Ways and Means Subcommittee on Health · 2025-02-11 · 119th Congress
The House Ways and Means Subcommittee on Health held this hearing to examine tools for preventing and managing chronic disease — employer wellness incentives, health savings accounts, multi-cancer early detection screening, and direct primary care — while hearing from witnesses in insurance, oncology, small-business benefits consulting, and health-policy advocacy. Begins at 0:22:46
Transcript
Highlights

Title

Chronic Disease Prevention, Wellness Incentives, and Coverage Cuts Debate

Purpose

The House Ways and Means Subcommittee on Health held this hearing to examine tools for preventing and managing chronic disease — employer wellness incentives, health savings accounts, multi-cancer early detection screening, and direct primary care — while hearing from witnesses in insurance, oncology, small-business benefits consulting, and health-policy advocacy. Chairman Vern Buchanan (R-FL) framed the hearing around the cost of chronic disease, while Ranking Member Lloyd Doggett (D-TX) and other Democrats used the hearing to warn about proposed Medicaid cuts, NIH funding reductions, and the expiration of ACA enhanced premium tax credits. Begins at0:22:46

Who spoke

Chairman Vern Buchanan (R-FL)0:22:46: Opened citing chronic disease costing Florida $3 trillion from 2016-20300:23:17, noted 72% of employers saw reduced health costs after wellness programs0:24:48, and cited a joint economic committee finding that obesity could cost the federal government $4.1 trillion over 10 years0:25:48; later questioned Tingle on Vitality's productivity impact0:54:08 and Carlson on lung-cancer screening barriers0:57:40.

Rep. Lloyd Doggett (D-TX), Ranking Member0:26:49: Argued the administration is pursuing cuts to pay for tax breaks while threatening research funding and public health data0:27:19; later detailed Texas's high uninsured rate, Medicaid's role for Austin children's hospital births, and a $300 million NIH funding loss projected for Texas0:59:411:03:43.

Brooks Tingle, CEO, John Hancock0:32:52: Described the Vitality program that rewards healthy behavior with premium discounts, run for 10 years0:33:53; said the company partnered with Grail's multi-cancer test in 20220:35:25 and does not receive customer test data to avoid a "chilling effect"2:13:57.

Dr. Jay Carlson, Mercy Clinical Research0:37:56: Described Mercy's Center for Precision Medicine and hereditary cancer screening reaching over 12,000 patient referrals0:42:00; reported 27 positive Grail MCED signals identifying 22 cancers, only 7 of which had traditional screening options2:10:55, and about four false positives with free follow-up retesting2:11:56.

Marcie Strouse, Capitol Benefits/NFIB0:43:30: Said small companies pay nearly twice as much for health coverage as large firms, with family premiums up 85% in eight years in her county0:45:02; advocated expanding HSA eligibility and allowing HSA funds for direct primary care memberships1:56:19.

Leslie Dach, Protect Our Care0:48:34: Warned proposed cuts would remove over $2 trillion from Medicaid, affecting 72 million people including 6 in 10 nursing home residents0:50:36; said letting ACA premium tax credits expire would raise premiums an average 90% for 20 million people and cause 5 million to lose coverage0:51:36; said Texas would lose $300 million in NIH funding under proposed cuts1:03:43.

Rep. Adrian Smith (R-NE)1:05:44: Argued the ACA delivered little despite promises and shifted costs1:05:44; questioned Strouse on HSA-qualified plan availability for small employers1:07:45.

Rep. Mike Thompson (D-CA)1:10:48: Cited proposed $4 billion annual NIH funding cuts and described UC Davis research on autism, cancer, and Alzheimer's1:11:49; asked Dach how NIH and Medicaid cuts would affect patient care1:13:50.

Rep. Kevin Hern (R-OK)1:14:51: Noted President Trump said he would not cut Medicare/Medicaid benefits1:14:51; cited ICHRA adoption growth of 29% between 2023-20241:16:52 and questioned Strouse on ICHRA regulatory barriers1:17:53.

A Southern California Democratic member1:20:25: Raised concerns about Musk's access to health data, Medicaid work-requirement proposals, and federal funding freezes affecting community health centers1:20:55; cited $4 billion in NIH cuts and diabetes affecting 38 million Americans1:21:25, and led a letter demanding restoration of removed women's health websites1:24:27.

Rep. Brian Fitzpatrick (R-PA)1:25:58: Cited six in ten Americans with a chronic disease and touted the bipartisan FIT Act and HOPE Accounts Act1:26:001:28:32; asked Carlson about the value of earlier cancer diagnosis1:28:32.

Rep. Dwight Evans (D-PA)1:32:04: Recalled his first job at Philadelphia's Rolling Hill hospital1:32:04; asked Dach what out-of-pocket costs would rise if the ACA/IRA were repealed, noting the IRA's $2,000 senior drug cap1:33:35.

Rep. Carol Miller (R-WV)1:35:06: Said 1.2 million West Virginians have a chronic disease costing the state over $10 billion annually1:35:36; described co-chairing the Congressional Kidney Caucus and noted ESRD is 1% of Medicare beneficiaries but 7% of Medicare spending1:36:36; asked Carlson about early screening for chronic kidney disease and rural cancer disparities1:37:371:39:39.

Rep. Danny Davis (D-IL)1:41:10: Argued research cuts would make Americans sicker1:41:10; said the University of Illinois would lose $67 million from proposed indirect-cost cuts1:43:12 and that 97% of foster children rely on Medicaid1:43:42.

Dr. Greg Murphy (R-NC)1:46:13: Argued family and educational factors drive chronic disease and criticized NIH accountability at specific universities1:47:14; pressed Carlson on balancing new genetic testing technology against limited healthcare funding1:49:16.

Rep. Claudia Tenney (R-NY)1:51:47: Said upstate New York small businesses face healthcare cost increases far above the 129% national 20-year average1:52:47; questioned Strouse on ICHRA/HSA expansion and direct primary care1:55:19.

Rep. Steven Horsford (D-NV)1:57:50: Said enhanced premium tax credits lowered his district's average marketplace premium from $514 to $145 per month1:59:20; asked Dach about the impact of letting the APTC expire, citing a 165% premium increase for a $31,000 earner2:00:502:01:21.

Rep. Blake Moore (R-UT)2:03:22: Highlighted his HOPE Act for tax-advantaged health savings accounts2:03:52; asked Strouse about HSAs for lower-income individuals2:04:22 and Carlson about diagnostic labs and Mercy's AI screening model2:07:24.

Rep. David Kustoff (R-TN)2:08:54: Asked Carlson about Mercy's experience with Grail's MCED test, including 3,000 physician referrals and false-positive handling2:09:55; asked Tingle whether John Hancock accesses customer test data2:12:57.

Rep. Linda Sanchez (D-CA)2:14:58: Cited $4 billion in NIH cuts announced February 7, with California losing over $800 million and Missouri $131 million2:15:28; listed Medicaid proposals including per-capita caps ($900 billion cut), work requirements ($100 billion cut), and provider tax limits ($175 billion cut)2:16:29.

Rep. Aaron Bean (R-FL)2:20:02: Contrasted 1970s health spending ($74 billion, 12% chronic disease) with today's $4.5 trillion and 42% with two or more chronic diseases2:20:32; questioned Strouse on HSA expansion and Tingle on obstacles to prevention screening2:22:032:24:34.

Rep. Don Beyer (D-VA)2:25:34: Criticized RFK Jr.'s record on vaccines and NIH funding freezes affecting Virginia Tech2:26:352:27:05; asked Dach repeatedly whether the administration's actions on NIH, Medicaid, and the ACA "create healthy options"2:29:062:29:37.

Rep. Terri Sewell (D-AL)2:30:07: Described her mother's death eight weeks after a pancreatic cancer diagnosis and her bill, HR 842, to cover multi-cancer early detection screening under Medicare starting at age 652:32:39; asked Carlson about barriers to Medicare coverage for MCED tests2:34:40.

Key moments

Dach said proposed reconciliation cuts would remove over $2 trillion from Medicaid, affecting 72 million people including 6 in 10 nursing home residents, and that letting ACA premium tax credits expire would raise premiums an average 90% for over 20 million people, causing 5 million to lose coverage entirely0:50:360:51:36.

Doggett said Governor Abbott's administration denied over 2 million Texans access to a family physician through administrative errors, and that Texas would lose $300 million in NIH funding under the proposed cuts0:59:411:03:43.

Carlson reported Mercy's use of Grail's multi-cancer early detection test produced 27 positive signals identifying 22 cancers, only 7 of which had existing traditional screening tests, with about four false positives followed by free retesting2:10:552:11:56.

Sewell described her mother's death from pancreatic cancer eight weeks after diagnosis at age 82, motivating HR 842 (named after her mother) to cover multi-cancer early detection tests under Medicare starting at 65, which drew over 300 co-sponsors last Congress2:32:392:33:40.

Sanchez cited state-by-state NIH funding-cut impacts: California over $800 million, Missouri $131 million, Texas over $300 million2:15:28.

Horsford said enhanced premium tax credits lowered average marketplace premiums in his district from $514 to $145 per month, and that expiration would cause a 165% premium increase for a $31,000 earner1:59:202:00:50.

Strouse said family premiums in the small-group market in her home county rose 85% over eight years, and small-business participation in offering coverage fell from nearly 50% to about 30% since 20140:45:020:45:32.

Tingle testified John Hancock does not access customer multi-cancer test results to avoid discouraging participation, though some customers voluntarily report that the tests "saved their life"2:13:572:14:28.

Miller and Carlson discussed chronic kidney disease: ESRD affects only 1% of Medicare beneficiaries but accounts for 7% of Medicare spending, and about 15% of adults have chronic kidney disease1:36:361:38:08.

Dr. Murphy argued Medicaid contains "waste fraud and abuse," citing a hypothetical 35-year-old remaining on Medicaid for back pain, while broadly defending continued NIH research funding for legitimate science1:50:461:47:44.

Metadata

CommitteeHouse Ways and Means Subcommittee on Health
Chamber / CongressHouse · 119th Congress
Date2025-02-11
TypeHearing
Witnesses
Dr. Jay Carlson — OBGYN and Clinical Chair, Mercy Clinical Research
Marcie Strouse — Small Business Owner and Partner, Capitol Benefits
Leslie Dach — Founder and Chairman, Protect Our Care
Brooks Tingle — CEO, John Hancock Financial
Videoyoutube
Transcript275 caption blocks · 22,303 words · 2:41:08 runtime
EventCongress.gov 117878