The health insurance industry isn’t selling peace of mind anymore—it’s selling a scam. Claims denials are skyrocketing, leaving Americans with expensive policies that barely cover anything. What used to be a rare occurrence is now a calculated profit center for insurers, and Democrats—always quick to claim they’re champions of “the little guy”—are letting it happen on their watch.
Back in 2013, major insurers like UnitedHealthcare and Humana denied less than 2% of claims. Fast forward to today, and some companies are rejecting nearly half of them, according to researchers at the Kaiser Family Foundation. That’s right—nearly half. How’s that for “affordable care”? If you’re sick and need serious medical help, your health insurance might just be the thing that drives you into bankruptcy. The Affordable Care Act (ACA), the crown jewel of Obama-era policy, requires the government to monitor and report these denial rates, but guess what? It doesn’t happen. Why? Because the same bureaucrats who lecture the rest of us about transparency are too cozy with the insurance companies to hold them accountable.
ACA plans are some of the worst offenders, with an average denial rate of 17%. Some plans, like Celtic Insurance Company in Florida, deny over 40% of claims. And yet, the Democrats still parade the ACA around as some kind of healthcare utopia. Maybe they should rename it the “Affordable Claims Denial Act.”
The excuses for these denials are laughable. Lack of medical necessity? Barely 2% of cases. Lack of prior authorization? Only 8%. The real kicker is the mysterious “other” category, which accounts for 76% of denials. Translation: They don’t need a reason—they just deny it because they can. Patients rarely appeal, and when they do, nearly half of those denials get reversed, proving that necessary care is being routinely denied. But who has time to fight the insurance machine? Certainly not doctors or families already overwhelmed by illness.
What’s worse, state and federal regulators are sitting on data that could expose the worst offenders but refuse to release it. Only two states—Connecticut and Vermont—disclose meaningful information. Meanwhile, the rest of the country is left in the dark. Young families are paying over $25,000 a year for health coverage they might never even use, and when they do, they discover their “insurance” is little more than a corporate lottery where the house always wins.
President-elect Trump has long criticized the incestuous relationship between federal regulators and big business, and the health insurance racket is a perfect example. Transparency isn’t a Republican or Democrat issue—it’s a fairness issue. Americans deserve to know which companies are playing games with their health, and it shouldn’t take a miracle to get the government to follow the laws already on the books.
Trump’s health team has already called out this unholy alliance between insurers and bureaucrats. Now it’s time to back those words with action. With an executive order and the right leadership, Trump can expose this racket and bring real accountability to an industry that desperately needs it. Unlike the Democrats, who created this mess with the ACA, conservatives believe in a healthcare system that works for the people—not against them. It’s time to drain this swamp, too.
