Healthcare Hearing Examines Barriers to Access and Affordability

The hearing came amid executive actions and federal enforcement focused on health care competition. President Donald Trump signed an executive order on health care price transparency on Feb. 25, 2025, directing the Treasury, Labor and Health and Human Services departments to implement and enforce existing transparency requirements.

Trump later signed Executive Order 14267, "Reducing Anti-Competitive Regulatory Barriers," on April 9, 2025. The order directed executive agencies to identify regulations that could impede competition and provide the Justice Department and Federal Trade Commission with lists of regulations imposing anticompetitive barriers.

What They're Saying

Three witnesses appeared before the subcommittee: Brian Blase, founder and president of the Paragon Health Institute; Brian Miller, an associate professor of medicine at Johns Hopkins University and vice chair of the North Carolina State Health Plan; and Katherine Martin, vice president of health affairs for the University of North Carolina System.

Fitzgerald argued that Affordable Care Act plans had increased in price at twice the rate of employer-sponsored plans. He also criticized certificate-of-need laws, which generally require health care providers to obtain state approval before opening certain facilities, expanding capacity or adding specified services.

Rep. Harriet Hageman (R-WY) highlighted the challenges rural residents face in accessing health care, saying Wyoming residents sometimes travel 50, 60 or 100 miles to reach a hospital.

Blase argued that government policies have contributed to consolidation and higher health care costs. He called for states to repeal certificate-of-need laws, stronger enforcement of hospital and insurer price-transparency requirements and changes to federal policies governing physician-owned hospitals.

Political Stakes

The hearing placed the Trump administration's competition agenda alongside congressional scrutiny of health care access, affordability and fraud.

The administration's actions include a Federal Trade Commission Healthcare Task Force launched on March 20. The task force coordinates the agency's health care enforcement and advocacy work, including competition and consumer-protection initiatives.

The FTC has identified consolidation and anticompetitive conduct in health care markets as areas of concern. Its broader health care enforcement activity has included merger challenges and actions involving pharmacy benefit managers, deceptive practices and competition among health care providers.

The hearing also highlighted differing approaches to the role of regulation in health care markets. A Goodwin analysisdescribed a shift in federal antitrust emphasis between the Biden and Trump administrations, with Trump-era regulators placing greater emphasis on eliminating regulatory barriers to competition.

Fitzgerald also pointed to North Carolina's certificate-of-need system, saying Republican state lawmakers had pursued efforts to repeal or scale back the requirements while Democratic Gov. Josh Stein opposed broader repeal.

The Bottom Line

The hearing record remained open for five legislative days for members to submit additional written questions and materials.

The hearing added to congressional scrutiny of how federal and state regulations, consolidation, insurance practices and fraud affect competition and affordability across U.S. health care markets.

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