hold on there's just too much going on in Congress lmao...
Penalizes insurers with high claim denials, offers refunds to members.
Sponsored by Rep. Craig (D-MN) and Rep. Ryan, referred to Energy & Commerce.
In committee, no House vote yet.
This bill would create new penalties for health insurance companies that deny 25% or more of claims. If an insurer is penalized, the money would go back to the individuals insured by that company. It also requires insurers to explain why they deny a claim for lack of medical necessity and report their overall denial rates. The bill was introduced by Representative Angie Craig (D-MN) and Representative Patrick Ryan (D-NY) and is currently being reviewed by the House Energy and Commerce Committee.
Introduced Apr 22, 2026
The bill was introduced in the House of Representatives on April 22, 2026, and sent to the House Energy and Commerce Committee for review. Before it can become law, the committee must approve it, then it would need to pass a vote in the full House, then pass the Senate, and finally be signed by the President.
If this bill passes, health insurance companies could be fined if they deny 25% or more of the claims they receive. These fines would then be given back to the individuals who were enrolled in that insurer's plan during the year the high denial rate occurred. Additionally, if your insurer denies a claim because they say it's not medically necessary, they would have to give you a clear explanation of their standards and why your service didn't meet them. Insurers would also have to publicly report their overall claim denial rates.
Supporters Say
Supporters say this bill holds health insurers accountable for excessive denials and provides refunds to affected policyholders.
Critics Say
The legislative text does not present specific arguments against this measure.
The provided bill text focuses on the mechanics of the proposed law and does not include detailed arguments from either supporters or critics of the legislation.