On October 20, 2021, the Senate Finance Committee held a hearing on “Health Insurance Coverage in America: Current and Future Role of Federal Programs”. Witnesses included former Congressional Budget Office Director (CBO) Dr. Douglas Holltz-Eakin, Executive Director of Families USA, Frederick Isasi, Vice President for healthcare coverage and access at the Commonwealth Fund Dr. Sara Collins, and Urban Institute fellow Dr. Linda Blumberg.

Chairman Ron Wyden (D-OR), in his opening remarks, said that health care is a human right, and the health care gap needs to decrease. He highlighted state fluctuation in Medicaid practices and prescription drug pricing resulted in a health care crisis.

While the goal of affordable and accessible health care was clearly bipartisan in the hearing, the means of how to achieve this goal was split between Democrats and Republicans. Senators across parties gave similar personal anecdotes regarding the negative effects of the health care system and debated the validity of solutions such as expanded Medicaid to all states, Medicare Advantage, the Build Back Better Bill, and the American Rescue Plan.

Although all senators agreed that the expansion of Medicaid to all states under the American Rescue Plan offered a safety net for American’s without employment health care benefits during the pandemic, Senator Bill Cassidy (R-LA), Senator Michael Crapo (R-ID), and Dr. Holtz- Eakin questioned the longevity and sustainability of the expansion as it paid for many people who did not have health care prior to the pandemic.

Senator Wyden (D-OG), Senator Sherrod Brown (D-OH), Dr. Collins, Dr. Blumberg, and Mr. Isasi argued for the expansion because it allowed over 3 million people to gain access health insurance, therefore decreasing the health care gap. Mr. Isasi emphasized that access to affordable health care improves well-being and allows for individuals to increase spending on food, rent, and utilities. Additionally, Dr. Collins stressed that individuals without Medicaid expansion in their state have increased loans, unpaid bills, and bad credit scores.

In response, Senator Cassidy (R-LA) expressed concern that Medicaid expansion would cost an estimate of $80 billion/year, according to a recent CBO report. Senator Elizabeth Warren (D-MA) and Senator Wyden (D-OR) rebutted those claims.

Senators also debated the effectiveness of market caps on prescriptions to lower prices. While Republicans and Dr. Holtz- Eakin deemed market caps as excessive government control, Democrats argued that the market is not protecting consumers and many low-income individuals do not qualify for decreased prices through Medicaid. In the comparisons made to other countries, Senator Debbie Stabenow (MI-D) questioned how the United States can be a wealthy economy yet unable to provide vulnerable citizens with health care. In response, Senator Crapo (R-ID) refuted these claims by arguing that high market prices correlate to quick prescription access and pharmaceutical research.

Overall, the passion for making affordable and accessible health care was shared across party lines, but an approach could not be agreed upon. No resolution was reached in the hearing, illustrating the long journey ahead in tackling more affordable and accessible health care in the U.S.