AHA finds insurance company policies 'deeply troubling'

Insurance-related barriers to care such as unaffordable deductibles and excessive requirements for prior authorization are "deeply troubling" amid the current open enrollment season, a Nov. 1 American Hospital Association letter addressed to HHS Secretary Xavier Becerra and Labor Secretary Martin Walsh contends.

While the country's hospitals and health systems are "eager and ready" to ensure every eligible individual and family has comprehensive care coverage, the behavior of some insurance companies is running counter to that aim, AHA President and CEO Richard Pollack, wrote in the letter.

The letter comes at a time when insurance companies are raking in higher profits at the same time as hospitals and health systems are facing financial turmoil.

Mr. Pollack, who said in the letter he was "increasingly concerned" by such behavior, pointed to denials for previously approved care and sudden changes in which providers patients can see, as well as the deductibles and excessive need for authorization, as prime areas where insurance companies are increasingly failing patients.

"The actions of some commercial insurers undermine these benefits and protections by increasing the complexity patients face in navigating the health care system and leaving patients vulnerable to unnecessary delays in care, or, in some cases, the denial of medically necessary care that should be covered," Mr. Pollack continued.

More must be done to ensure adequate oversight of commercial insurance behavior, he urged.

"Individuals and families should feel assured that the plan they choose during open enrollment will actually be there for them when they need care," Mr. Pollack concluded.

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