ACEP to Congress: Stronger Policies, Accountability Can Stop Bad Insurer Behavior

WASHINGTON, DC-The American College of Emergency Physicians (ACEP) welcomes today's Congressional hearings examining the bad insurer behavior that drives up premiums and increases health care costs for millions of people, limiting access to affordable insurance.

"ACEP strongly supports robust enforcement of laws and regulations meant to halt patterns of insurer misconduct that have only become more egregious in recent years," said ACEP President L. Anthony Cirillo, MD, FACEP.

"…insurers continue to exploit our health care system and the individuals and families they ostensibly cover, all for the sake of increasing record profits," ACEP warned in a statement submitted to the House Ways and Means and Energy and Commerce committees ahead of today's hearings with insurance executives.

ACEP cited a range of abusive and unscrupulous tactics, including explicit violations of the No Surprises Act, abuse of prior authorization procedures, repeated attempts to undermine and erode the federal prudent layperson standard, and outright denials of necessary care.

Emergency medicine is unique in that it requires that anyone coming to an emergency department be evaluated and treated or stabilized, regardless of their insurance status or ability to pay, consistent with the federal Emergency Medical Treatment and Labor Act (EMTALA). As a result, emergency medicine involves more uncompensated care than any other medical specialty. According to an April 2025 RAND report, across all payers, 20% of emergency physician payments go entirely unpaid, a $5.9 billion annual shortfall that exacerbates resource constraints and hinders access to emergency care.

Insurers compound the existing strain on emergency physicians by doing all they can to delay, deny and avoid their payment obligations. "The persistent failure of insurance companies to conduct business in good faith will keep driving up costs and impeding access to care, unless they are stopped," said Dr. Cirillo.

ACEP continues to lead efforts with regulators, policymakers and bipartisan lawmakers to improve insurer transparency, accountability, and compliance with existing laws, so that emergency physicians can focus on saving lives rather than solving billing issues, and patients can access the care they need and deserve without fear of financial ruin.