Trump Signs MAHA Bombshell EO Set to Turn American Healthcare on its Head: ‘Will Help Millions’
Blue Cross Blue Shield of Alabama tops the list of health insurers with the highest in-network claim denial rates, rejecting a staggering 35 percent of claims submitted by patients in 2023, according to data from KFF/CMS Transparency in Coverage Data.
This means more than one in three patients who sought care within their network still faced denials despite following their insurer’s guidelines. The data also reveals a troubling pattern among major insurers nationwide, with UnitedHealth Group following closely behind at 33 percent, while Health Care Service Corporation denied 29 percent of claims.
This revelation comes at a pivotal moment as President Donald Trump signs a new executive order aimed at forcing healthcare providers and insurers to publicly disclose their actual prices to consumers.
The order represents an escalation of Trump’s efforts from 2019, when he first introduced regulations requiring price transparency that many providers have only partially implemented or openly resisted.
Other significant offenders include Molina Healthcare (26 percent), Elevance Health (23 percent) and CVS (22 percent), according to the data outlined by Daily Mail. The bottom tier of this concerning list shows Blue Cross Blue Shield of Tennessee, Cigna Health, and CareSource all denying 21 percent of in-network claims submitted by their members.
These alarming figures paint a picture of an insurance industry where claim denials have become commonplace, potentially leaving millions of Americans with unexpected medical bills despite maintaining insurance coverage and carefully selecting in-network providers.
“This price transparency executive order is a major statement from President Trump. Healthcare price transparency will help millions of Americans and will be a cornerstone in President Trump’s healthcare legacy,” said Andrew Bremberg, former assistant to Trump and director of the Domestic Policy Council at the Trump White House, per Daily Mail.
The outlet went on to note that healthcare prices have traditionally operated behind a veil of secrecy, determined through private negotiations among doctors, hospitals, pharmaceutical companies and insurers. Those involved have fiercely guarded these figures, arguing that confidentiality is essential to their bargaining process – a position that critics say allows inflated pricing to continue unchecked.
Trump’s push for transparency faces significant opposition from powerful interests within the healthcare industry. Insurance groups have argued that such regulations could actually raise premiums, while hospital groups during Trump’s first term claimed that disclosing prices for all services violated their First Amendment rights and would diminish their negotiating power with insurers.
Despite this entrenched resistance, the administration is moving forward aggressively.
The latest executive order directs the Departments of Treasury, Labor and Health and Human Services to rapidly implement and enforce Trump’s healthcare price transparency measures, which the White House claims were “slow walked by the prior administration.”
The order specifically calls for ensuring that hospitals and insurers disclose actual prices rather than estimates, making prices more comparable across different facilities and insurance companies, and updating enforcement policies to ensure compliance with these requirements.
The previous implementation efforts yielded disappointing results, Daily Mail highlighted. Trump’s 2019 order imposed a $300-a-day fine on non-compliant hospitals, but this penalty proved insufficient to drive widespread adoption, with only 14 percent of hospitals fully adhering to the rules by 2022. The new order seeks to address these enforcement shortcomings.
Advocates for price transparency see tremendous potential in these measures to transform American healthcare.
Daily Mail reported that Cynthia Fisher, founder and chairman of PatientRightsAdvocate.org, stated, “Real prices will forever transform the American healthcare system. Price transparency unleashes competition and shifts the power to the true purchasers of care — patients, employers, and taxpayers — allowing them to lower their costs and be protected from overcharges.”
Fisher illustrated the potential impact with specific examples that highlight the vast price disparities currently hidden from consumers: “Why would anyone pay $3,000 for an MRI when they could get the same quality for $300? Likewise, no patient would agree to pay a $12,000 colonoscopy bill when the fair market price is around $1,000.”
This executive order on price transparency follows another recent order aimed at expanding access to in vitro fertilization (IVF) and reducing its costs.
Barbara Collura, president and CEO of Resolve: The National Infertility Association, expressed optimism about the IVF initiative, noting that “the biggest barriers for people to building their families are the out-of-pocket costs, the lack of insurance coverage for this care.”
While Trump’s transparency push builds on efforts initiated during the Obama administration, when then-HHS Secretary Kathleen Sebelius oversaw the disclosure of hospital list prices, the current initiative aims to dig deeper by revealing the actual prices paid by insurers—information that has traditionally been kept secret through confidential negotiations among healthcare stakeholders.
The high denial rates showcased in the KFF/CMS data underscore why such transparency measures might be necessary.
When more than a third of claims are denied by certain insurers even for in-network care, patients are left vulnerable to unexpected costs and administrative burdens attempting to appeal these decisions.
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