Insurance companies must reveal how often they deny coverage—and whether they're wrong.
H.R. 9396 — Prior Authorization Accountability Act · Filed by Craig Goldman (R-TX) · 5 cosponsors · Introduced Jun 23, 2026 · Markup held
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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.
The full analysis lists 4 implications of this text.
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)