Welcome to the House Committee on Energy and Commerce

WASHINGTON, D.C. – Today, Congressman Morgan Griffith (VA-09), Chairman of the Subcommittee on Health, led a hearing titled Lowering Health Care Costs for All Americans: An Examination of Health Insurance Affordability, featuring witness testimony from the biggest health insurance plan CEOs in the United States. During the hearing, Committee Republicans held health insurance plans accountable in their role of increasing health care affordability challenges impacting all Americans and discuss how Democrat policy failures in Washington D.C. have warped the American health care system and hurt patients access to high-quality health coverage options.

“Many patients have fewer plan choices than they did before Obamacare was enacted. Therefore, Obamacare coverage is not translating to patient or taxpayer affordability,” said Chairman Griffith. “We owe it to patients to have a health system that offers real choices, transparent prices, and coverage that fits their needs, and I look forward to seeing how today’s conversation presents solutions to make health care more affordable for all Americans.”

Watch the full hearing ** here **.

Below are key excerpts from today’s hearing:

Congressman Brett Guthrie (KY-02): “Experts, including the Congressional Budget Office, estimated that the expiration of the temporary Obamacare enhanced COVID Credit is projected to increase premiums by anywhere from 4 percent and 8 percent, depending on the market. Yet, many areas for 2026, insurers requested and were approved for premium increases of 30 percent, 40 percent, even 50 percent. So, Mrs. Boudreaux, you’re in Kentucky. The average Elevance Obamacare plan increased its premium by roughly 24 percent. Despite what Democrats would have the American people believe, the temporary COVID Credit does little to actually lower underlying Obamacare premiums and the American taxpayers are footing the bill. So, Mrs. Boudreaux, by your best estimation—even if the Democrats’ temporary COVID Credits were extended—would Obamacare plan bids in my state of Kentucky increase or decrease between 2026 and 2025?” Mrs. Boudreaux: “Well, thank you very much for the question, Congressman. You know, as we’ve shared, premiums reflect the underlying costs...” Chairman Guthrie: “So, they would have increased, right?”

Congressman John Joyce, M.D. (PA-13): “Since the passage of the ACA, we have seen costs across all markets continue to increase. One of the key issues driving this is the medical loss ratio, or the MLR, that requires plans to spend either 80 percent or 85 percent of your premium dollars on health care expenses. The MLR created multiple perverse incentives for insurance companies to dramatically consolidate both vertically and horizontally. The companies that you lead today are not just involved in insurance. You own PBMs, you own specialty pharmacies, you own retail pharmacies, you own GPOs, you own physician groups and practices. In some cases, you own hospitals, and you own drug manufacturing companies. And at least one of you owns a bank! This has led to alleged cases of self-dealing, as your companies work to circumvent the [multi-level marketing] requirements.”

Congresswoman Mariannette Miller-Meeks (IA-01): “The largest PBMs—CVS Caremark, Express Scripts, and Optum—have created rebate contracting entities, or PBM group purchasing organizations, which are adding to the complex and opaque nature of the medicine supply chain. My first PBM reform bill on transparency was in 2019, as an Iowa state senator. PBMs claim these entities provide them and their clients with greater bargaining power to lower costs, but recent investigations by Members of Congress, industry experts, state attorneys general, and federal oversight agencies suggest the opposite may be true. We have a graph up here. Let’s start with the left. The drugmaker pays rebates directly to the PBMs and PBM GPOs to ensure their drugs are included on their health plan formularies—meaning the drugs are covered by insurance. Then, these PBMs and their PBM GPO subsidiaries collect the rebates, which they promise to pass through to their patients and health plans. Can any of you tell me what percentage of rebates are passed through to the patient, who is paying a higher drug cost because the rebates are added to the price of the drug?” Top Health Insurers: “...” Congresswoman Miller-Meeks: “Is it zero?” Top Health Insurers: “...” Congresswoman Miller-Meeks: “You don’t even know that you’re not giving these patients back a rebate for paying higher drug prices.”

WASHINGTON, D.C. – Today, Congressman Gary Palmer (AL-06), Chairman of the Subcommittee on Environment, led a hearing titled Chemicals in Commerce: Legislative Proposal to Modernize America’s Chemical Safety Law, Strengthen Critical Supply Chains, and Grow Domestic Manufacturing.

“The process for reviewing new chemicals – which was a significant focus of the 2016 effort – is broken. This regulatory uncertainty makes it difficult for the chemical industry to bring safer alternatives or new technology to the market in the U.S. and impacts human health and the environment by slowing the transition to safer alternatives,” said Chairman Palmer. “The bill would reauthorize the fee provision for another 10 years and require increased transparency and accountability in how fees are used by EPA.”

Watch the full hearing here.

Below are key excerpts from today’s hearing:

Congressman John Joyce, M.D. (PA-13): “Dr. White, we've had this discussion and my colleagues have opened the door, but I want to give you an opportunity to speak to how provisions in this legislative proposal today will guide EPA to focus their consideration on conditions that reasonably could be foreseen, and not just theoretical or even unlikely, because I think we're opening up potential areas that will waste time to be able to allow important chemicals to be assessed. Can you discuss that for us, please?” Dr. White: “For every single chemical that the EPA has evaluated since TSCA was modernized, they have found it to be an unreasonable risk. This has really been because of their scientific practices and principles. They have ignored submitted data. They have mischaracterized worst case exposure scenarios and not understood what exposure actually looks like when they're making decisions. And they focused on conditions of use that were not relevant or that were not really going to provide or have a specific high level of exposure. So, this has led to really flawed assessments by the agency, leading to overly conservative risk management decisions by the agency. What this new approach does is it requires the agency to focus on those conditions of use that are more likely than not to occur. So, it really helps to, again, focus the agency on looking at actual real-world scenarios for how a chemistry might be used.”

Congresswoman Mariannette Miller-Meeks (IA-01): “For states like Iowa, where agriculture, manufacturing, including chemical manufacturing, and innovation are central to our economy, we need a regulatory system that protects human health and the environment without relying on duplicative regulation or unnecessary delays. This discussion draft refocuses TSCA on real world risk, best available science, and coordination with other federal and international regulators. It encourages safer innovation, strengthens domestic supply chains, and ensures EPA is accountable for its decisions while preserving strong protections for workers, consumers, and families.”

Congressman Gabe Evans (CO-08): “One of the processes that's used at EPA to manage and look at these chemicals and do cost benefit analysis is what's called a risk evaluation. In your experience, do EPA's risk evaluations and subsequent risk management rules provide health and safety benefits that are commensurate with the costs and burdens of the rules? And if not, what can we do to address that?” Dr. White: “EPA's risk evaluation process can be improved upon. It has a best available science and a way to vet the scientific evidence statute that it should be relying on. It has been missing the mark over the last several years. And so, there's really an opportunity to strengthen that, maintain that language.”

WASHINGTON, D.C. – Congressman Gary Palmer (AL-06), Chairman of the Subcommittee on Environment, delivered the following opening statement at today's hearing titled Chemicals in Commerce: Legislative Proposal to Modernize America's Chemical Safety Law, Strenghten Critical Supply Chains, and Grow Domestic Manufacturing.

Subcommittee Chairman Palmer’s opening statement as prepared for delivery:

“Good afternoon and welcome to Ranking Members Pallone, Tonko, my colleagues, and to our witnesses for this hearing of the Subcommittee on the Environment.

“Today we will be examining a legislative proposal to modernize the Toxic Substances Control Act – or TSCA.

“First enacted into law in 1976 with broad bipartisan support, TSCA provides the U.S. Environmental Protection Agency (EPA) with broad authority to regulate chemicals that pose an unreasonable risk to human health and the environment.

“Forty years later, Congress made several improvements to TSCA with passage of the bipartisan Lautenberg Amendments in 2016.

“As we heard at our hearing last January, chemicals are central to many aspects of modern life, and a strong, U.S. chemical industry is key to our economic prosperity and national security.

“The 2016 law authorized EPA to collect user fees to help provide resources and funding but in the decade since the Lautenberg Amendments were passed, it has become clear that this important law is still not working as Congress intended and that further changes are needed to ensure chemicals are reviewed in a predictable and efficient process without undermining safety.

“The process for reviewing new chemicals – which was a significant focus of the 2016 effort – is broken. As we heard in January and will again hear from witnesses today, EPA does not meet the 90-day review deadline for the vast majority of all new chemicals submitted for EPA review. This regulatory uncertainty makes it difficult for the chemical industry to bring safer alternatives or new technology to the market in the U.S. and impacts human health and the environment by slowing the transition to safer alternatives.

“To be clear: The draft would not scrap the safety protections enacted in the 2016 Amendments and is not reopening up TSCA as a whole.

“The bill would reauthorize the fee provision for another 10 years and require increased transparency and accountability in how fees are used by EPA.

“The draft also makes targeted changes to modernize section 5 and section 6 concerning the review and regulations of new and existing chemicals, including requiring increased coordination between EPA and other agencies and prioritizing chemicals that are essential to critical manufacturing supply chains.

“Our witnesses today are: Dimitri Karakitsos, a partner at the law firm Holland & Knight who worked on the 2016 Amendments as a Senate staffer; Dr. Kimberly Wise White of the American Chemistry Council, John Carey of DSM-Firmenich, an international chemical manufacturer with significant operations in the U.S., and Professor Tracey Woodruff of the University of California, San Francisco.

“The legislation we are considering today is a discussion draft. It reflects input the Subcommittee received at our January hearing and in the months since.

“Majority staff also met with their counterparts on the minority staff half a dozen times to discuss ideas and language for this proposal, and several changes were made to the text based on input from minority staff.

“We look forward to getting additional feedback in the weeks after this hearing and hope to continue discussions with the minority on areas for bipartisan cooperation as we work on an updated draft, prepare legislation for introduction, and plan for a future markup to advance this important legislation.”

WASHINGTON, D.C. – Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, Congressman John Joyce, M.D. (PA-13), Chairman of the Energy and Commerce Subcommittee on Oversight and Investigations, Congressman Morgan Griffith (VA-09), Chairman of the Energy and Commerce Subcommittee on Health, Congressman Jason Smith (MO-08), Chairman of the House Committee on Ways and Means, Congressman David Schweikert (AZ-01), Chairman of the Ways and Means Subcommittee on Oversight, and Congressman Vern Buchanan (FL-16), Chairman of the Ways and Means Subcommittee on Health, authored ** a letter ** to the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) requesting a meeting on the concerning evidence detailed in the letter that points to large-scale, ongoing Medicare fraud in Los Angeles County, along with what action is being taken to address the situation.

“The House Committee on Energy and Commerce has an extensive history of digging deeper into matters where program integrity has been compromised. This letter is crucial in our commitment to eliminating waste, fraud, and abuse in federal health care programs,” said Chairmen Guthrie, Joyce, and Griffith. “Republicans have spent much of this Congress furthering legislation to protect our most vulnerable Americans—especially seniors, but our work is not done. Continued oversight is crucial to uphold the integrity of programs that serve our most vulnerable populations. We applaud the ongoing work being conducted by HHS-OIG in cracking down on the fraud that has occurred, and we look forward to addressing the larger-scale scheme that is draining public resources from Americans who need these services the most.”

“Medicare home health and hospice fraud directly undermines the safety and reliability of care for America’s most vulnerable seniors. Auditors have reported an unprecedented jump in home health and hospice fraud in Los Angeles County, California – including one report showing 112 different hospices located at the same physical address. With $1.2 billion in improper payments in home health claims and the Inspector General reporting $198 million in suspected hospice fraud, Gavin Newsom’s California could just as well be another Minnesota,” said Chairman Smith. “The Ways and Means Committee will not hesitate to use our broad oversight authority to get to the bottom of this and protect taxpayers and vulnerable patients against these bad actors.”

BACKGROUND:

Evidence has strongly suggested large-scale Medicare fraud involving home health agencies (HHA) and hospice agencies in Los Angeles County, California, noting that such practices not only drain public resources but also compromise the quality of care provided to patients, especially those most vulnerable populations.

• The Centers for Medicare and Medicaid Services (CMS) found that the 2023 improper payment error rate for home health claims was 7.7 percent, or about $1.2 billion, in 2023.
• In terms of hospice care, HHS OIG reported suspected hospice fraud to be an estimated $198.1 million in fiscal year (FY) 2023.
• CMS has placed HHAs as an area of high risk for Medicare fraud.

Emerging concerns over Medicare fraud in the HHAs and hospice sector highlights heightened activity, specifically in Los Angeles County.

• From 2019 through June 2023, HHAs in the U.S. decreased from 8,838 to 8,280 (6 percent), while, at the same time, HHAs in Los Angeles County increased from 896 to 1,309 (46 percent).
• More than 1,400 new Los Angeles County HHAs enrolled in Medicare in the last five years, representing over 50 percent of all HHAs in the state of California and nearly 14 percent of all HHAs in the country.

Based on data from the March 2022 California State Auditor’s Report and from HHS on hospice ownership, Los Angeles County had more than 31 percent of the hospice agencies in the U.S. in 2022.

• There were approximately 58 million seniors in the U.S. in 2022, with Los Angeles County having approximately 1.49 million seniors (2.5 percent).
• The report highlighted indicators that included a “rapid, disproportionate growth in the number of hospice agencies” and “excessive geographic clustering of hospice agencies,” noting that 112 different licensed hospice agencies were located at the same physical address.
• State auditors in California estimated that hospice agencies in Los Angeles County likely overbilled Medicare by $105 million in 2019.

These accounts of widespread fraud occurring in Los Angeles County’s HHAs and hospice agencies have raised concerns about whether home health and hospice Accrediting Organizations (AO) are effectively examining such organizations at the time of their enrollment in Medicare.

• In November 2024, CMS issued a Quality, Safety, and Oversight memo to surveyors, reminding them to closely inspect hospices’ Medicare enrollment documents to understand changes in ownership and location, but neglecting to encourage AOs to pursue other commonsense antifraud measures.

In April 2025, HHS OIG announced that the Office of Audit Services would compile a report for FY 2026 to identify trends, patterns, and comparisons that could indicate potential vulnerabilities related to new Medicare hospice provider enrollments.

In May 2025, the Health Care Fraud Strike Force—a joint task force of federal, state, and local law enforcement agencies, including HHS OIG—** announced multiple arrests ** following a multi-year investigation into Armenian Organized Crime, which dismantled five hospices in the greater Los Angeles area.

On November 28, 2025, CMS ** announced ** the Calendar Year 2026 Home Health Prospective Payment System Final Rule, providing comments that suggest an interest in addressing the aforementioned accounts of fraud.

WASHINGTON, D.C.  – Today, Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, and Congressman John Joyce, M.D. (PA-13), Chairman of the Subcommittee on Oversight and Investigations, sent a letter to the Centers for Medicare and Medicaid Services (CMS) requesting a briefing to better understand the Department of Health and Human Services’ (HHS) recent actions and ongoing work to enhance safety within the organ procurement and transplantation system. On Thursday, September 18, 2025, the Department of Health and Human Services (HHS) announced major efforts to improve safety, transparency, and efficiency within the organ procurement and transplantation system, including the decertification of an organ procurement organization (OPO) for the first time in U.S. history. According to the announcement , the decision was made “after an investigation uncovered years of unsafe practices, poor training, chronic underperformance, understaffing, and paperwork errors.” The Committee has a history of ensuring patient safety remains the highest priority in our organ procurement and transplantation system, as evident from the Committee’s work last Congress on organ transplantation and donation issues as well as its oversight this Congress. As a part of its ongoing investigation, the Committee requests that CMS respond to questions, including those related to the decertification of the OPO in South Florida and the prevalence of incidents similar to those outlined in the Health Resources and Services Administration’s (HRSA) investigative report, to ensure patient safety remains a top priority. Read the full letter HERE . “While the Committee applauds efforts taken by CMS to uphold the highest standards of care to which all OPOs are expected to adhere, HHS’s announcement decertifying the Life Alliance Organ Recovery Agency illustrates the urgency of this moment and why the subcommittee is not finished with our oversight of the organ transplant system,” said Chairmen Guthrie and Joyce. “It is our moral obligation as members of Congress to establish safeguards and prevent these harmful practices from persisting further, and we look forward to obtaining answers from the agency about the prevalence of these incidents, as well as how CMS plans to proceed with prioritizing patient safety first and foremost.” Background: During the 118th Congress, the Committee on Energy and Commerce led the passage of the Securing the U.S. Organ Procurement and Transplantation Network Act to both modernize the Organ Procurement and Transplantation Network (OPTN) and allow HRSA to institute a competitive contracting process to find the best contractors for various OPTN functions. This legislation was signed into law on September 22, 2023.  On March 20, 2024, the Committee launched an investigation into the organ procurement and transplantation system by sending a letter to United Network for Organ Sharing (UNOS) requesting information related to concerns surrounding data security and operability, patient safety and equity, and conflicts of interest.   On March 20, 2024, the Committee also sent a letter to HRSA requesting information related to implementation of the Securing the U.S. Organ Procurement and Transplantation Network Act as well as other concerns related to effective oversight and management.  On September 11, 2024, the Subcommittee on Oversight and Investigations held a hearing that focused on the implementation of reforms at the OPTN, including the need for stronger oversight and accountability as well as ongoing patient safety concerns.  During the hearing, questions were raised related to allegations of mismanagement and patient safety concerns after patients began exhibiting signs of increased neurologic function after being previously deemed suitable as an organ donation candidate. Several of these allegations, particularly those related to patient safety, were later substantiated through the findings contained in HRSA’s March 2025 report.  On March 24, 2025, HRSA’s Division of Transplantation issued a report that summarized the findings of its investigation into KYDA, the OPO now known as Network for Hope, which serves Kentucky and parts of Ohio, West Virginia, and Indiana.   HRSA’s investigation examined an “index case” and an additional 351 unique cases of authorized, not recovered (ANR) patients. This means that the patients were considered for donation after circulatory death recovery, but no organs were transplanted. The report showed that nearly 30 percent of the cases “had concerning features.” The concerning features included problems with patient-family interactions, medical assessments and team interactions, recognition of high neurologic function, and recognition and documentation of drugs in records.  On May 28, 2025, HRSA issued a corrective action plan to the OPTN, which directed the OTPN to take specific actions within a specified period of time, including developing a 12-month OPTN monitoring plan for KYDA to address concerns identified. The corrective action plan also requires the OPTN to propose policies for public comment to improve safeguards for potential donation after circulatory death (DCD) patients in the organ procurement process and increase information shared with patient families regarding DCD organ procurement.  On July 22, 2025, the House Committee on Energy and Commerce’s Subcommittee on Oversight and Investigations held a hearing examining concerning practices within our nation’s organ procurement and transplant system that were identified by HRSA’s investigation.  On September 12, 2025, the Committee sent a bipartisan letter to HRSA requesting a briefing on its ongoing oversight of patient safety in our nation’s organ procurement and transplant system. ###

WASHINGTON, D.C. – Yesterday, Congressman John Joyce, M.D. (PA-13), Chairman of the Subcommittee on Oversight and Investigations, and Congressman Gary Palmer (AL-06), Chairman of the Subcommittee on Environment, sent a letter to Gene Dodaro, the Comptroller General of the Government Accountability Office (GAO), requesting an assessment of available or emerging technologies and materials that could be used to supplement critical minerals in semiconductors. “Critical minerals such as lithium, cobalt, and rare earth elements are essential for technologies used in many sectors of the economy, including energy, transportation, national defense, health care, and consumer electronics,” said Chairmen Joyce and Palmer . “These minerals are vulnerable to supply-chain disruptions for several reasons, including U.S. reliance on foreign sources, as well as the rapid growth in demand for critical minerals in the U.S. and abroad.” CLICK HERE to read the full letter. The letter asks the GAO to examine: The status of domestic technologies and supplemental materials, such as critical minerals found in mine waste, tailings, or reclaimed from end-of-life batteries and electronic waste, that can serve as substitutes for foreign-sourced critical minerals from non-allied nations needed for semiconductors and energy grid or power electronics, including impacts on material and product performance. Key technological challenges to the development or adoption of these domestic supplemental and materials to advance the diversification of U.S. critical mineral sources. BACKGROUND: In May, the Subcommittee on Oversight and Investigations held a hearing on ways to enhance our critical mineral supply chains. Energy and Commerce Committee Republicans are committed to strengthening our critical mineral supply chains and finding solutions to reduce our reliance on foreign sources, particularly when it comes to foreign adversaries like China. The Trump Administration has also worked hard to bolster these supply chains. Critical minerals are essential to American technologies and industries, and finding innovative domestic solutions that can contribute to our independence from non-allied nations is essential as we work to onshore American innovation and strengthen our national security. ###