Insurers Hedge on Trump-Backed Pledge To Improve Denials Process

A year after major health insurers pledged to reduce barriers to care, KFF Health News reports many now say they won't fully implement those promised changes. The June twenty twenty-five pledge was meant to reform prior authorization — where insurers require approval before treatment. The industry claims an eleven percent reduction in prior authorizations, six point five million cases. But critics say that number obscures a larger truth: insurers still deny necessary care, and the promised reforms lack enforcement teeth. Rep. Greg Murphy, a Republican physician who participated in the announcement, now says the pledge has failed. When Betsy Adler switched to Medica, which signed the pledge, during her pregnancy, she was assured her cardiac care would be covered at in-network rates. But the insurer started processing some claims as out-of-network, leaving the family more than four thousand dollars in unexpected bills — even after they tried to correct the error. Researchers say without legal mandates and government accountability, insurers have no real incentive to change. The House Ways and Means Committee has advanced a bill requiring Medicare Advantage plans to disclose prior authorization policies and report denial data — a move toward the enforcement that voluntary pledges have repeatedly failed to provide.

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