NEW: Georgians Report Experiencing Prolonged Pain as Insurance Companies Deny or Delay Care Doctors Say They Need

Click here to read Sen. Ossoff's third report from his ongoing investigation into health care costs, loss of services, and delays or denials of needed care

Washington, D.C. - A new report from U.S. Senator Jon Ossoff reveals insurance companies are denying or delaying care Georgians' doctors say they need.

Today, Sen. Ossoff released the third report of his investigation into the impacts of rising health care costs, cuts to health care services, and delays or denials of medically necessary health care due to issues with "prior authorization," where an insurance company can deny care even if doctors prescribe patients the treatment they say they need.

The report includes stories from Georgia patients who have reported that prior authorization issues with their insurance companies have resulted in delays and denials of medically necessary health care, leading, in some cases to prolonged painful symptoms and a lower quality of life.

Last month, Sen. Ossoff released the investigation's second report, which detailed how Georgians suffering delays or denials of medically necessary health care faced untreated life-threatening conditions, and/or severe financial hardship. Sen. Ossoff's first report detailed stories of Georgians who report they have been delaying necessary care and are paying thousands more for care after the loss of the ACA tax credits, with some saying they've lost insurance altogether because of the high costs.

In January, Sen. Ossoff launched an investigation into the impacts of rising health care costs and cuts to health care services, and in June, Sen. Ossoff urged Georgians to share stories of insurance companies denying or delaying medically necessary health care.

"No American should be delayed or denied needed health care. It is unacceptable that Americans, who are paying record premiums to insurers making record profits in the world's richest country, are nevertheless denied medically necessary care," Sen. Ossoff said. "I will continue exposing these practices and working to ban insurance companies from denying or delaying needed health care."

As detailed in the report, Georgia patients are reporting denials of needed health care procedures, which they say have prolonged painful symptoms:

• Patricia Moore, based in Valdosta, has been suffering from a pinched nerve in her spine for over a year. She has received multiple injections to ease her pain and, last year, she received two MRIs with two different surgeons, both of whom recommended that she receive an urgent surgery. However, her insurance company refused to cover the cost of the surgery, reportedly requiring that Mrs. Moore attend several weeks of physical therapy and stating that her pinched nerve was not yet "severe" enough to require surgery. Mrs. Moore did physical therapy for four weeks, and reports that it increased her pain. She has "drop foot" in her left foot due to the nerve damage, which makes her prone to tripping. Her physical therapist determined that physical therapy will not alleviate her symptoms. Mrs. Moore reports that her pain has "taken over her whole life." She struggles to stand in the kitchen, she can barely get up from the toilet, and she has not been able to travel to see her son in Indiana since 2025. She feels depressed and is experiencing financial stress, as the physical therapy visits were not fully covered by her insurance. Her doctor submitted an appeal to the insurance company to authorize the spine surgery, but the appeal was denied in August. Mrs. Moore reports that she has been fighting with the insurance company since May to authorize the surgery her doctor says she needs and says she "no longer has any will to get up in the morning because no one wants to help [her]."

• Makita Thatcher, based in Macon, was injured in a car accident when she was eighteen years old. Today, at 34 years old, she struggles with pain from her injuries. Her doctor has recommended that she receive rehabilitation services to lessen her pain and to preserve her mobility. Her insurance company has repeatedly denied authorization for the rehabilitation services, and Ms. Thatcher is worried about whether her injury will worsen in the future and what to do if she is re-injured.

Georgia patients also report delays in medically necessary health care procedures have lowered their quality of life:

• Medha Kallem, based in Atlanta, is a medical student who has severe migraines. Without her medication, she reports that she experiences as many as 20 migraines each month, but that number is reduced to only about two migraines when she can take her medication. She reports that her insurance company has failed to timely authorize her medication, leading to gaps in her treatment that have affected her academic performance and led her to have to limit her travel, social plans, and time with her family.

A Johns Hopkins study found that the practice of prior authorization, where patients must seek approval from their insurance company before receiving care, was "associated with disease exacerbation, preventable hospitalization, prolonged hospital stay, and lower rates of disease-free survival."

According to KFF, virtually all seniors enrolled in Medicare Advantage must obtain prior authorization for some services, and in 2024 over four million of these requests were denied.

Additionally, KFF also found that of the approximately 85 million Affordable Care Act (ACA) in-network denied claims in 2024, less than 1% were appealed, forcing patients either to pay for services out-of-pocket, despite having "coverage," or forgoing care - solely because of decisions made by insurance companies.

Sen. Ossoff continues to work to ban insurance companies from denying or delaying needed health care.

In July, Senate Republicans blocked a Senate resolution cosponsored by Sen. Ossoff to stop the Trump Administration from allowing artificial intelligence to improperly deny seniors' needed health care.

In June, during the Senate's vote series, Sen. Ossoff offered an amendment to prevent insurance companies from denying or delaying needed health care, but Senate Republicans blocked Sen. Ossoff's amendment. This followed Senate Republicans blocking Sen. Ossoff's amendment during a Senate budget debate in April.

In April, Sen. Ossoff launched an inquiry with CMS Administrator Dr. Mehmet Oz about insurance practices that lead to denied claims and delayed health care that patients need.

Click here to read Sen. Ossoff's new report: Georgians Report Insurance Companies Are Denying or Delaying Care Their Doctors Say They Need.

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