Disrupt. Delay. Deny.

Many commercial health insurance policies and practices often disrupt, delay and deny medically necessary care to patients.

We’ve seen many examples of patients’ stories highlighted recently in the media. And patients, doctors and nurses on the front line of providing care to patients say many of these insurers’ practices are getting worse.

As part of AHA’s continued efforts to hold some commercial health insurance companies accountable when they have demonstrated irresponsible behavior, we released this week results of three surveys conducted by Morning Consult on behalf of the AHA. The surveys found that the vast majority of patients, nurses and physicians say commercial insurer policies and practices are reducing access to medical care, driving up health care costs and increasing clinician burden and burnout.

According to the survey:

  • 83% of patients say their health care providers — not insurers — know the best treatment for them and should be the one to make treatment decisions.
  • 62% of patients say that their household experienced an insurance-related barrier to treatment over the last two years, a trend that caused many of these patients to reportedly become sicker.
  • At a time when insurers are reporting record profits, 54% of patients reported either that health insurance was too expensive as part of their family budget, had difficulty affording insurance, or both.

Irresponsible commercial insurer policies don’t just limit health care access for patients, they also interfere with doctors’, nurses’ and other clinicians’ ability to do their jobs during a time of severe workforce challenges.

The Morning Consult polling found that 84% of nurses say insurers’ administrative policies delay patient care, and 80% of physicians say that burdensome insurer policies affect their ability to practice medicine, taking them away from their patients’ bedside.

Hospitals and health systems also are facing increased denials and payment delays from some commercial health insurers. During a time of significant financial strain for many hospitals, 50% say they have not been paid for claims totaling $100 million or more for more than six months, according to a report we released last year. Meanwhile, 7 in 10 hospitals said they are still dealing with outstanding claims from 2016 or before.

Here’s the good news: we’re making progress in addressing these issues — in both regulatory actions and proposed legislation — and we’ll keep up the advocacy efforts and public pressure.

Health insurance should be a bridge to medical care for patients, not a barrier to it. If we want to expand access to care and address the health care workforce crisis, then we must hold commercial insurance companies accountable for these harmful practices.

Related News Articles

Andrea Preisler, AHA’s senior associate director of administrative simplification policy, explains why the recent final rule requiring Medicare Advantage,…
The Centers for Medicare & Medicaid Services (CMS) Jan. 17 finalized new regulations aimed at reforming the prior authorization process.The new rule will:…
The Centers for Medicare & Medicaid Services Jan. 17 released a final rule requiring Medicare Advantage, Medicaid and federally facilitated Marketplace…
The AHA Nov. 20 released its Health Care Plan Accountability Update, covering the latest developments in Medicare Advantage, legislation and regulation of…
A three-judge panel in federal court last week partially revived a class action lawsuit against UnitedHealth Group subsidiary United Behavioral Health,…
In the first quarter of 2023, household debt in America rose to $17.05 trillion, representing a precipitous increase over the last decade. In part, rising debt…