Who’s to Blame for Your Lousy Insurance Coverage?
18th December 2024
Everyone’s blaming health insurance company greed for the soaring claims denials and roadblocks to care. That’s naive. Follow the money to find the real culprits: lying politicians.
In 2013, before Affordable Care Act regulations kicked in, insurers denied roughly 1.5% of claims, according to the American Medical Association. But under ACA rules, denials increased tenfold. Now nearly 15% of claims are denied, reports Premier, an insurance consultant firm. Some insurers deny a third or more of claims, according to Kaiser Family Foundation research.
Insurers are also demanding preauthorizations for a wide range of treatments and medications, tying your doctor’s hands and dangerously delaying your care.
Your doctor has to call the insurer before beginning treatment or ordering a medication. Seldom is the person on the other end of the phone a specialist in the disease or treatment in question. It could be an OB-GYN overriding what your neurosurgeon recommends, warns the AMA.