Part of our core mission? Exposing the Left's blatant hypocrisy. Help us continue the fight and support the 2024 Year-End Campaign now.

December 18, 2024

Who’s to Blame for Your Lousy Insurance Coverage?

Americans are sicker and living shorter lives than they were before the ACA.

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.

Dr. Debra Patt prescribed a drug combination for a patient with metastatic breast cancer but had to wait weeks for prior authorization. In the meantime, reports the AMA, she had to settle for standard chemotherapy, to no avail: Her patient died.

“You have health plan representatives who have never met the patient, have never been at the bedside or practiced medicine but are now making treatment decisions,” objects Tina Grant, senior vice president of public policy and advocacy at Trinity Health, a system of 92 Catholic hospitals.

According to House Committee on Energy and Commerce testimony, 80% of the preapprovals Cigna denied for Medicare Advantage customers were overturned on appeal, a sign that legitimate care is being withheld. Cigna uses an algorithm called PxDx to deny prior authorizations in bulk.

Denials and prior authorization requirements escalated after the ACA went into effect. But don’t blame profit maximization. The ACA regulates underwriting profits, and if profits go up, insurers have to send customers rebates.

Giants like United Healthcare have grown into money-making behemoths by buying physicians’ practices, hospitals and pharmacy chains, not by selling health plans, according to IBISWorld industry research.

The actual reason your health insurance is becoming unreliable is that politicians backing Obamacare knowingly made a promise that was impossible to keep without insurers resorting to predatory practices.

Obamacare advocates promised everyone would be charged the same regardless of their “preexisting conditions.”

The math doesn’t work. Every year, 5% of the population uses over 50% of the health care. That’s a fact of nature, politics aside.

Telling insurers to cover the 5% for the same price they charge healthy people is like providing monthly groceries to a skinny fashion model and the winner of Nathan’s Hot Dog Eating Contest for the same price. Ridiculous.

Five percent more premium payers and 50% more medical needs.

The federal government should have stepped in with extra payments to cover people with preexisting conditions. Instead, insurers were hit with a mountain of new claims and told to make it work. They adopted draconian cost-cutting methods.

The winners? Democratic politicians. Covering preexisting conditions at no extra charge is popular.

The losers? Everyone else who has to worry that their next treatment will be delayed or their next claim denied.

The biggest losers, sadly, are the seriously ill who suffer disproportionately from managed care’s tight controls, according to a National Bureau of Economic Research paper on Medicaid managed care.

More than half of states are now passing laws to limit prior authorization.

That’s a step in the right direction. But Americans need to reassess managed care.

There is next to no evidence that it improves health.

President Joe Biden’s assistant secretary of health policy boasts that the ACA’s coverage expansion — mostly in managed care — reduced “morbidity and mortality.” That’s a blatant lie. Americans are sicker and living shorter lives than they were before the ACA.

One alternative is to allow low-cost catastrophic insurance, which kicks in only for the large bills. Healthy people who get coverage at work would benefit from fewer interactions with an insurer and more take-home pay in lieu of a whopping $25,000 plan — the cost this year for family coverage.

Democrats try to label catastrophic coverage as “junk insurance.” The Biden administration made it almost impossible to buy. But Americans are beginning to see that health plans that turn down claims and make you wait a dangerous amount of time for preauthorization are the real “junk.”

COPYRIGHT 2024 CREATORS.COM

Who We Are

The Patriot Post is a highly acclaimed weekday digest of news analysis, policy and opinion written from the heartland — as opposed to the MSM’s ubiquitous Beltway echo chambers — for grassroots leaders nationwide. More

What We Offer

On the Web

We provide solid conservative perspective on the most important issues, including analysis, opinion columns, headline summaries, memes, cartoons and much more.

Via Email

Choose our full-length Digest or our quick-reading Snapshot for a summary of important news. We also offer Cartoons & Memes on Monday and Alexander’s column on Wednesday.

Our Mission

The Patriot Post is steadfast in our mission to extend the endowment of Liberty to the next generation by advocating for individual rights and responsibilities, supporting the restoration of constitutional limits on government and the judiciary, and promoting free enterprise, national defense and traditional American values. We are a rock-solid conservative touchstone for the expanding ranks of grassroots Americans Patriots from all walks of life. Our mission and operation budgets are not financed by any political or special interest groups, and to protect our editorial integrity, we accept no advertising. We are sustained solely by you. Please support The Patriot Fund today!


The Patriot Post and Patriot Foundation Trust, in keeping with our Military Mission of Service to our uniformed service members and veterans, are proud to support and promote the National Medal of Honor Heritage Center, the Congressional Medal of Honor Society, both the Honoring the Sacrifice and Warrior Freedom Service Dogs aiding wounded veterans, the Tunnel to Towers Foundation, the National Veterans Entrepreneurship Program, the Folds of Honor outreach, and Officer Christian Fellowship, the Air University Foundation, and Naval War College Foundation, and the Naval Aviation Museum Foundation. "Greater love has no one than this, to lay down one's life for his friends." (John 15:13)

★ PUBLIUS ★

“Our cause is noble; it is the cause of mankind!” —George Washington

Please join us in prayer for our nation — that righteous leaders would rise and prevail and we would be united as Americans. Pray also for the protection of our Military Patriots, Veterans, First Responders, and their families. Please lift up your Patriot team and our mission to support and defend our Republic's Founding Principle of Liberty, that the fires of freedom would be ignited in the hearts and minds of our countrymen.

The Patriot Post is protected speech, as enumerated in the First Amendment and enforced by the Second Amendment of the Constitution of the United States of America, in accordance with the endowed and unalienable Rights of All Mankind.

Copyright © 2024 The Patriot Post. All Rights Reserved.

The Patriot Post does not support Internet Explorer. We recommend installing the latest version of Microsoft Edge, Mozilla Firefox, or Google Chrome.