Insurance companies must reveal how often they deny coverage—and whether they're wrong.

What it does

This bill requires health insurance plans and issuers to publicly disclose detailed data about their prior authorization practices starting in 2027, including approval/denial rates by service, appeal outcomes, decision times, and whether automated technology was used. The goal is to make it transparent how often insurers deny coverage requests and whether those denials are later overturned on appeal, so patients and regulators can see which plans are most restrictive.

Why we flagged it

The bill's core mechanism is mandatory public disclosure of prior authorization denial and appeal data by insurers and plans. It is a transparency and accountability measure, not a substantive change to coverage rules or benefits.

What the text implies

• Disclosure of AI/machine-learning use in denials may expose algorithmic bias in coverage decisions, potentially triggering regulatory or litigation pressure on insurers.
• Public comparison of denial rates across plans on ACA Exchanges (added in Section 3) could shift enrollment toward lower-denial plans, creating competitive pressure on restrictive insurers.
• Median/average decision times by service may reveal systemic delays that harm patients awaiting urgent care, creating political pressure for faster determinations.
• Appeal reversal rates (showing denials later overturned) may demonstrate that initial denials are often incorrect, undermining insurer credibility and increasing appeals volume.

Who it affects

Ordinary people gain visibility into how their insurance plans make coverage decisions, enabling them to compare plans, challenge denials with evidence of patterns, and hold insurers accountable. Patients and doctors can see which services face the highest denial rates and appeal success, reducing information asymmetry that currently favors insurers.

Who stands to gain

• health insurance plans with low denial rates (competitive advantage)
• patient advocacy organizations (data for litigation/lobbying)
• healthcare providers (evidence to challenge denials)

Named in the bill

HHS Secretary, CMS, ACA Exchanges, ERISA, Internal Revenue Code, health insurance issuers, group health plans, prior authorization, AI/machine-learning technology

Where it stands

6 cosponsors: 3 Democrats, 3 Republicans.

• Jun 23, 2026 — Introduced · Congress.gov: “Introduced in House”
• Jun 23, 2026 — Referred to House Committee on Education and Workforce and House Committee on Ways and Means · Congress.gov: “Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and…”
• Jun 25, 2026 — Markup held in committee · Congress.gov: “Subcommittee Consideration and Mark-up Session Held”

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

Money around this bill

7 lobbying clients named this bill on 8 disclosure filings across 1 quarter, Jun 2026 to Jun 2026. Those filings disclosed $8,063,000 in lobbying spend. A filing names 34 bills on average, so that figure is what each filing reported, not a share belonging to this bill.

More lobbying clients named this bill than 86% of bills with at least one filing.

Craig Goldman, the sponsor, reported $682,667 in PAC receipts in the 2026 cycle.

• American Medical Association — $5,643,000 on 2 filings
• American Clinical Laboratory Assn — $890,000 on 1 filing
• Cambia Health Solutions — $700,000 on 1 filing
• Blood Cancer United (fka the Leukemia & Lymphoma Society) — $590,000 on 1 filing
• Lundbeck LLC — $180,000 on 1 filing

Lobbying Disclosure Act filings through Jul 20, 2026. A filing shows who paid to lobby on a bill it names, not what changed.