Insurance companies must reveal how often they deny your coverage

What it does

This bill requires health insurance companies and Medicare Advantage plans to publicly disclose detailed data about how often they deny coverage requests, approve them, and reverse denials on appeal. Insurers must report this information annually, broken down by type of request, reason for denial, whether AI or humans made the decision, and how long decisions took. The goal is to give patients and the public transparency into insurance denial practices so they can see which insurers deny coverage most often and why.

Why we flagged it

The bill's core mechanism is a mandatory public disclosure requirement for insurance denial data. It does not regulate denial rates, pricing, or coverage decisions themselves—only transparency into existing practices. This is a disclosure-and-accountability measure, not a substantive insurance reform.

What the text implies

• Disclosure of AI/algorithmic decision-making may expose insurers to litigation or regulatory scrutiny if patterns suggest discriminatory outcomes, even if unintentional.
• Standardized reporting formats set by HHS could become a template for future regulatory action (e.g., denial-rate caps or penalties), expanding government oversight incrementally.
• Public disclosure of denial reversal rates on appeal may create reputational pressure on insurers to approve more appeals, potentially raising premiums if approval rates shift significantly.
• Requirement to disaggregate by 'reason for denial' may force insurers to standardize and codify denial criteria, reducing ad-hoc decision-making but also creating discoverable evidence in litigation.

Section numbers refer to the bill text the analysis read — linked under Primary records below.

Who it affects

The bill creates enforceable transparency requirements that directly serve patients and the public by exposing insurance denial patterns, enabling informed plan selection and policy scrutiny. No offsetting costs to citizens are imposed; the burden falls on insurers to report data they already collect. Transparency itself strengthens accountability and consumer choice.

Named in the bill

Health insurance issuers, Medicare Advantage (MA) organizations, Department of Health and Human Services (HHS), Secretary of HHS, JNJ, BMY, AIG, FBK, PRU

Where it stands

2 cosponsors: 2 Republicans.

• Aug 3, 2026 — Introduced · Congress.gov: “Introduced in House”
• Aug 3, 2026 — Referred to House Committee on Ways and Means and House Committee on Energy and Commerce · Congress.gov: “Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a…”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.