House Health Leaders Urge Trump Administration to Stop Health Insurance Companies from Improperly Denying Claims

House Health Leaders Urge Trump Administration to Stop Health Insurance Companies from Improperly Denying Claims

WASHINGTON - Today, House health leaders urged the Trump Administration to tackle wrongful claim denials by group health plans and insurance companies and secure coverage for working people under the Employee Retirement Income Security Act (ERISA)-the largest source of health insurance in the U.S. This letter comes after troubling reports of health plans and corporate middlemen conducting arbitrary, improper, and mass denials of health claims.

Ranking Member Robert C. "Bobby" Scott (VA-03), House Committee on Education and Workforce, and Ranking Member Mark DeSaulnier (CA-10), House Subcommittee on Health, Employment, Labor, and Pensions (HELP), sent the letter to Employee Benefits Security Administration (EBSA) Assistant Secretary Daniel Aronowitz.

"Improper claim denials impose substantial health and financial hardships on individuals, leading to delays in necessary treatments, worsened health outcomes, and high out-of-pocket costs…. In far too many tragic cases, denials lead to the unnecessary deaths of people who have earned benefits through their plan, but are nonetheless denied the care that could have saved their lives," wrote the Ranking Members.

ERISA provides the EBSA Assistant Secretary with the authority, and the duty, to protect the health benefits of approximately 136 million American workers, retirees, and their families. To that end, the Ranking Members encouraged the EBSA Assistant Secretary to take decisive action to address health claim denials and provided commonsense recommendations, including implementing a long-delayed requirement to collect data on claim denials and improving Americans' ability to appeal wrongful claim denials.

The Ranking Members also urged the Trump Administration to adequately staff EBSA to ensure it can fulfill its enormous mission. Since returning to office, the Trump Administration has cut EBSA's staffing by over 20 percent, impeding the agency's ability to protect workers who are wrongfully denied benefits by their health plans.

To read the full letter, click here.

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