Source: Modern Healthcare
Republicans turned against the health insurance industry, at least rhetorically, in 2025 as they struggled to deflect criticism of their healthcare policies.
Democrats bombarded the GOP over healthcare throughout the year, chiefly about the more than $1 trillion in Medicaid and health insurance exchange cuts in President Donald Trump’s tax law and the expiration of enhanced exchange subsidies. Trump and others responded by pointing the finger at Democrats, the Affordable Care Act of 2010 and the insurance sector.
Some Republicans were already raising concerns about the market power of large insurers and healthcare conglomerates. But this became a party-wide talking point late in the year, with Trump and congressional GOP casting the insurance industry as the true beneficiary of the subsidies, not the millions of their constituents who received them.
House Republican leaders repeatedly averred that insurers were raking in inappropriate profits from the ACA. Many of their rank-and-file members went further.
“They are the problem,” said Rep. Rick Allen (R-Ga.). “The insurance lobby came in and wrote Obamacare.”
“The insurance industry has become the third wing of the Democratic party,” said Rep. Dr. Greg Murphy (R-N.C.). “I’m getting to the point where I’m really tired of for-profit insurance companies.”
“They’re the modern day money changers. They just take their cut, like the mob. They just take their cut off the top and jack up the prices,” Rep. Tim Burchett (R-Tenn.) said.
At a House Rules Committee session Dec. 16, Rep. Austin Scott (R-Ga.) went so far as to read out the 2024 revenue figures for three leading insurers — UnitedHealth Group, CVS Health and Cigna — saying they totaled more than $1 trillion.
“I’m not under the impression that giving these companies any money at all in the form of these enhanced Affordable Care Act subsidies — and it’s the enhanced Affordable Care Act subsidies that they would get — would then, all of a sudden [lead them to] treat the American consumer fairly,” Scott said.
Political observers have noted the populist, Jacksonian shift, but it remains to be seen how sincere it is or whether it will lead to an actual shift in how GOP lawmakers treat healthcare or the insurance industry.
“Some of the criticism of health insurance companies is at least somewhat genuine, a reflection of the GOP’s newfound dislike of concentrated power,” said Kyle Kondik, managing editor of the University of Virginia Center for Politics publication Sabato’s Crystal Ball.
But Kondik doesn’t see it driving Republicans to more progressive solutions. “Do these Republicans suddenly support single payer? I doubt it,” he said. “Clearly, a lot of Republicans don’t know where they want to go on healthcare policy, and it’s not hard to criticize insurance companies while they try to figure it out.”
Nevertheless, the anti-insurer tone is likely to have impacts in 2026, from shaping any compromise that might be achieved on the exchange subsidies to other policies that have bipartisan support.
Rep. Dr. Andy Harris (R-Md.), the influential chair of the conservative House Freedom Caucus, said any deal on subsidies would have to hem in insurers.
“If it’s not part of a much larger, transformational package that deals with the exorbitant profits of health insurance companies that come at the expense of actually delivering healthcare to Americans, then nothing’s going to happen,” Harris said.
The ire directed at insurers will likely find outlets in other less controversial areas, particularly with House Speaker Mike Johnson (R-La.) pledging to spend the first half of 2026 addressing healthcare issues to blunt Democratic attacks.
For instance, legislation that has stalled for two years to rein in some insurers’ practices are much more likely to be priorities. Congress has considered tighter rules for prior authorizations, primarily in Medicare Advantage, but many members have been eying the broader market, as well. Medicare Advantage “upcoding” is also getting more attention from conservatives.
Similarly, bills to crack down on the pharmacy benefit manager subsidiaries of CVS Health, UnitedHealth Group and Cigna started out focused on government programs but increasingly target the whole industry, most recently in a House-passed bill that includes sweeping transparency and reporting requirements for PBMs.
While it is difficult to predict how Congress will deal with even bipartisan ideas in a high-stakes election year, the insurance industry has noticed the negative tone.
Mike Tuffin, CEO of the insurance trade group AHIP, has been reaching out to lawmakers, a spokesperson said. Tuffin joined Rep. Aaron Bean (R-Fla.) for a panel discussion on healthcare costs on Dec. 4.
Tuffin told lawmakers and staffers at the event that insurers only earn modest profits while navigating a complex environment. ”To make health insurance more affordable, we have to make healthcare more affordable,” he said.
“Health insurance premiums simply reflect the underlying cost of medical care across the covered population, along with a modest and regulated risk margin,” Tuffin said. According to AHIP, the profit margin across the health insurance sector was 0.8% in 2024.
Many Republicans, however, are not buying that argument and they did not heed AHIP’s pleas to extend the subsidies.
Harris scoffed at the idea others in the health system are driving up costs, particularly doctors like him.
“The bottom line is that I don’t know any physician or physician practice whose value increased 1,100% since Obamacare was established,” Harris said, referring to what he said was UnitedHealth Group’s growth.
