One medical expert says that last year's assassination of a health insurance CEO has prompted insurers to change one common policy that is particularly unpopular with the American public.
NBC News reported Monday that the health insurance industry has communicated to President Donald Trump's administration that it will soon be making efforts to fix its "prior authorization" process, in which insurers have to sign off on any treatment, procedure or medication doctors prescribe before patients can receive them. Insurers are now allowing patients who change insurance plans during treatment to have prior authorization approvals honored for a 90-day period for similar care. They also plan to make it easier to submit prior authorization requests online by 2027. AHIP (formerly American Health Insurance Plans) which is the primary lobbying group for the industry, estimated that approximately 257 million Americans could be impacted.
Health and Human Services Secretary Robert F. Kennedy Jr. said that several major health insurers including UnitedHealth, Blue Cross Blue Shield, Cigna, Aetna, Humana and Kaiser Permanente, among others, would be implementing changes to prior authorization across private insurance plans along with Medicaid plans and Medicare Advantage plans. But one expert is not optimistic that the changes would be significant.
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Harvard Medical School assistant professor Dr. Adam Gaffney, who is a critical care physician, told NBC that insurers are "going to streamline [prior authorization] in some incremental ways only." However, he suggested that the December 2024 murder of UnitedHealth CEO Brian Thompson was a primary motivator for the change.
"There’s violence in the streets over these issues," Gaffney said.
Both Kennedy and Centers for Medicaid and Medicare Services Administrator Mehmet Oz said on Monday that insurance companies had made previous promises to change the prior authorization system, but had yet to follow through. Oz specifically pointed to two instances in both 2018 and 2023 in which they pledged to make changes, but failed to implement them.
The shooting of Thompson triggered both a nationwide manhunt for the shooter, and a nationwide demand for reform of the health insurance industry. 26 year-old Luigi Mangione was ultimately arrested for allegedly shooting Thompson, and investigators have called attention to a journal Mangione allegedly had in his possession that listed multliple grievances with the health insurance industry — including the prior authorization process.
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Click here to read NBC's full report.