Democrats Urge Federal Action On Health Care Claim Denials

I am so old I can remember when insurance of all kinds was a state prerogative.  No more.  The Federal Government is now fully in control of health insurance and Democratic lawmakers are demanding it act on health insurance claims denials:

https://michiganadvance.com/2025/11/18/repub/trump-administration-urged-by-us-house-dems-to-act-on-health-insurance-claim-denials/

Trump administration urged by US House Dems to act on health insurance claim denials
By Shauneen Miranda - November 18, 2025

WASHINGTON — Two leading Democrats on a U.S. House panel called on the head of an agency within the U.S. Department of Labor responsible for protecting workers’ benefits to take action to address improper health insurance claim denials, in a Tuesday letter provided exclusively to States Newsroom.

Reps. Bobby Scott of Virginia and Mark DeSaulnier of California — the respective ranking members of the House Committee on Education and Workforce and its Subcommittee on Health, Employment, Labor, and Pensions — offered three recommendations to Daniel Aronowitz. He is the assistant secretary of the DOL’s Employee Benefits Security Administration, or EBSA.

“Improper claim denials impose substantial health and financial hardships on individuals, leading to delays in necessary treatments, worsened health outcomes, and high out-of-pocket costs,” Scott and DeSaulnier wrote.

“In far too many tragic cases, denials lead to the unnecessary deaths of people who have earned benefits through their plan, but are nonetheless denied the care that could have saved their lives,” they added.

Improvements called for in collecting data on denials

As head of EBSA, Aronowitz is responsible for administering, regulating and enforcing Title I of the Employee Retirement Income Security Act, or ERISA, which is intended to protect participants’ and their beneficiaries’ interests when it comes to benefit plans under their employers.

DOL estimated roughly 136 million participants and beneficiaries were covered by approximately 2.6 million ERISA-covered group health plans in 2022.

As part of their recommendations, Scott and DeSaulnier called on Aronowitz to “implement long-delayed transparency requirements to collect data on health claim denials by insurance companies and group health plans.”

The two suggested building upon Form 5500, ERISA’s annual reporting requirement, to “improve data collection from group health plans.”

Staffing at agency, Trump budget cuts cited

Scott and DeSaulnier also urged Aronowitz to “commit to fully enforcing the law and to ensuring that EBSA is adequately staffed to fulfill its mission,” pointing to a decline in more than a fifth of the agency’s staff under President Donald Trump’s administration.

Trump’s fiscal 2026 budget request for DOL also called for $181 million in funding for EBSA, a $10 million proposed cut from the prior fiscal year.

The Senate Appropriations Committee passed its annual bill to fund DOL, including EBSA, back in July and maintained funding for the program in fiscal 2026 at $191 million.

The corresponding panel in the House also approved its bill to fund DOL in September, aligning with the administration’s request of cutting funding for EBSA by $10 million in fiscal 2026.

The Democrats also recommended Aronowitz take steps to “improve consumers’ ability to appeal wrongfully denied health benefits.”

They encouraged the assistant secretary to consult the Advisory Council on Employee Welfare and Pension Benefit Plans and to “reverse” DOL’s current posture regarding the council.

Scott and DeSaulnier noted that DOL took several steps to “undermine” the council, including “delaying public release of its report, purging documents such as testimonies from consumer advocates from the Department’s website, and, to date, failing to convene the Council for any of the four statutorily-mandated meetings.”

The department did not immediately respond to a request for comment Tuesday.