California Nurses Association (CNA) and its more than 100,000 members across California today share their support for Assembly Bill 682, new legislation authored and introduced by Assemblymember Liz Ortega of Hayward. The new bill would mandate public reporting on the denials of insurance claims for California’s patients, something nurses believe can expose the broken trust between insurers and patients at the root of our broken health care system.

“Insurance companies see our patients as numbers on a spreadsheet, but they’re real people to us as nurses at their bedsides,” said Michelle Gutierrez Vo, RN and president of CNA. “Having publicly available information on why insurers deny claims is a major move to expose how health care is systematically denied to our patients. Nursing is about building trust with our patients; this bill will reveal how that trust is often broken by our healthcare system”

“Millions of Californians are paying high monthly premiums for their health insurance ― only to find that when they get sick and need it, their claims are denied,” said Assemblymember Ortega. “Statistics on health insurance denials are not made public. But the numbers we have from Healthcare.gov paint an alarming picture: One in five claims are denied even if you remain in-network. If you’re forced to seek care out-of-network, you have nearly a 50/50 chance of having your claim denied.”

The new bill seeks to mandate collection and public reporting of health insurance claims denial information for each health plan regulated by the California Department of Managed Health Care (DMHC) and the California Department of Insurance (CDI). The information collected and reported would include the number of claims denied, the costs of denied claims, whether or not artificial intelligence was used in the decision, and — significantly — reasoning for denying claims, such as a lack of prior authorization or an out-of-network provider. This information will be especially relevant for denied claims for timely, life-saving care.

Taken together, these measures will publicly document why insurance claims are denied, exposing the tactics insurance companies use to delay or deny coverage for patients. As documented in recent media reporting and as nurses see every day, the current system leaves patients with little to no information from health insurers who have tried to keep denial processes secret. But there is overwhelming public support for mandating public reporting of this information.

While California prides itself on a low uninsured rate, CNA nurses support A.B. 682 in order to expose how health care plans are deliberately underinsuring customers, leaving nurses’ patients without essential health care and with no explanation why care has been denied.

California Nurses Association/National Nurses United is the largest and fastest-growing union and professional association of registered nurses in the nation with more than 100,000 members in more than 200 facilities throughout California and more than 225,000 RNs nationwide.