When President Obama was selling his health-care law in 2009, he declared, “Your health insurance should be there when it counts, not just when you’re paying premiums but when you actually get sick, and it will be when we pass this plan.”
But more than a decade after its 2010 passage was hailed by progressives as a victory for health-care accessibility, consumers have seen a startling rise in health-insurance-claim denials.
One of the most popular provisions of Obamacare was the one that required insurers to cover applicants with preexisting conditions and that barred insurers from charging more for premiums based on health status. Insurers initially responded by offsetting costs with higher premiums, exiting some markets, and offering plans with fewer choices of doctors, hospitals, and other health-care providers. In recent years, carriers have reacted in another way — outright denying medical claims, a practice that Obamacare was explicitly designed to prevent.
A recent study by the Kaiser Family Foundation featured in a Washington Post opinion piece highlighted some sobering figures. In 2021, denial rates for insurance claims averaged 17 percent, and some insurance companies have taken this strategy so far that their denial rates have ballooned to an almost unbelievable 80 percent. Among other examples, the Post article described one California patient who had his claim for a heart procedure denied despite having received the insurer’s pre-approval.
Part of the increase can be attributed to the growing use of automated systems in claim denials. These systems can decline claims within seconds, often without even checking the patient’s medical records.
Critics of Obamacare have always pointed to the distinction between expanding insurance coverage and expanding actual access to health care. While the law spent trillions of dollars to address the former, it has failed to fix the latter problem — and this is just the latest example.