The DNA Act

Access to Affordable Healthcare vs. Insurance Companies 

Have you or someone you know ever been denied a medical procedure or course of treatment by your insurance company? If you answered yes, you are not alone. People are being sent home without the treatment they need because insurance companies are denying them coverage. Or they find themselves in crippling debt while trying to stay healthy. There is no winning here. The system is broken. Health insurance claim denials have burdened working Americans for decades. In 2005, the Commonwealth Fund reported that 79 million Americans were struggling with medical bills and or debt. Today, health care costs remain one of the top causes of bankruptcy for American families.

In 2023, a Kaiser Family Foundation survey found that 60 percent of insured adults experience problems with their health insurance. According to HealthCare.gov, insurance companies deny nearly 1/5 of submitted claims. That means insurance companies are making medical decisions for one in five Americans. There’s clearly something wrong with this. Doctors go through years of school, training, and take the Hippocratic oath to make judgment calls. Last I checked, insurance companies are not licensed to give medical advice.

According to the CEO and cofounder of Komodo Health, claim denials have increased by 16% from 2018 to 2024, particularly for generic drugs such as insulin and albuterol. Other findings show that in 2021, 291.6 million in-network claims were received, of which 48.3 million were denied. This is a clear sign of a broken system.

Denial & Inequality

Patients are facing denials because certain procedures are not “medically necessary,” or so says the insurance company. The insurance companies claim they need more information or that the patient needs to run through more clinicals. This process makes sick patients jump through hoops before they can receive the medical treatment their doctor recommends. Insurance companies should be advocating for patient care. Instead, they are overriding the advice of medical professionals. And if they want to play that role, then they should be accountable for putting the patient at risk. 

Not all health insurers report how many claims they deny, making it difficult to track. The Affordable Care Act (ACA) established guardrails in the complex insurance process. Some things the ACA did were to hold insurance companies accountable by requiring explanations for claim denials and by implementing an appeals process for denied claims. But what is even more concerning is that less than one percent of denials are appealed. Unfortunately, not everyone has the time, knowledge, or resources to challenge a denial. A study shows that only 0.1% of all people who experience a denial actually appeal. This only exacerbates healthcare inequality. 

New Challenges: AI-Driven Tech

While new technology can be more efficient, it brings more room for error. Many health insurance companies have transitioned into using an automated system that instantly rejects claims on medical grounds without even opening the patient's file. Several health insurance giants, including UnitedHealth, Humana, and Cigna, are facing lawsuits over using AI to deny health insurance claims. Brown University School of Public Health Dean, Dr. Ashish Jha, says data suggests 25 to 30 percent of claims are being denied by AI technology. This is dangerous because we are dealing with human lives. Every patient deserves to have their file thoroughly reviewed by a human being, not skipped over by an automated system. 

Something is Broken

America is one of the richest countries in the world, yet we still have not found a solution to provide access to basic, life-saving healthcare for all. I have big dreams for our country, but I must be realistic: I cannot fix our broken system overnight. But I can work toward a goal. Article I of the U.S. Constitution grants all legislative powers to a bicameral Congress: a House of Representatives and a Senate that are the result of a “Great Compromise,” seeking to balance the effects of popular majorities with the interests of the states. So, we can inch towards the bigger picture, adopt reforms, and introduce laws and policies that will help provide more healthcare to more people. When elected, I am ready to write and sponsor legislation that represents the people. Legislation that will plant seeds and, over time, grow into what we have set out to achieve—a democracy that serves the people. 

DNA Act

The DNA (Doctors not Accountants) will change how health insurance works in the United States. And this proposed change is simple: only a licensed medical doctor, who has taken the Hippocratic oath, shall have the authority to deny a medical procedure submitted to insurance by a practicing physician. Only medical doctors may make medical decisions, and the risk for insurance shall be more evenly allocated between insurance companies and their insured patients. The DNA Act will save lives. This piece of legislation can help provide affordable access to healthcare and ensure that those who seek healthcare can live longer, happier, and healthier lives. 

Americans deserve high-quality, low-cost healthcare without worrying that their insurance company will deny them coverage for the care they need. For the care their doctor recommends. Change like this takes the burden off the American people. The burden of a large hospital bill and the burden of dealing with insurance companies. And when people are healthy, they can work, function, and provide for themselves and their families. The bottom line is that healthcare is a human right, and insurance companies do not have the authority to take this right away from the American people—no one does. 

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Survey: 79 million Americans Have Problems with Medical Bills or Debt | Commonwealth Fund, https://www.commonwealthfund.org/publications/newsletter-article/survey-79-million-americans-have-problems-medical-bills-or-debt.

Bond & Botes Law Offices, Health Care Costs Number one cause of bankruptcy for American families ABI, https://www.abi.org/feed-item/health-care-costs-number-one-cause-of-bankruptcy-for-american-families.

Pearl Steinzor & Giuliana Grossi, How insurance claim denials harm patients’ health, finances AJMC (2025), https://www.ajmc.com/view/how-insurance-claim-denials-harm-patients-health-finances.

Kffraynaw, Claims denials and appeals in ACA Marketplace plans in 2021 KFF (2025), https://www.kff.org/private-insurance/claims-denials-and-appeals-in-aca-marketplace-plans/.

Melody Schreiber, New AI tool counters health insurance denials decided by automated algorithms The Guardian (2025), https://www.theguardian.com/us-news/2025/jan/25/health-insurers-ai.

Health Insurers’ AI systems causing “explosion of denials,” warns Brown’s Public Health dean, CNBC (2024), https://www.cnbc.com/video/2024/12/09/health-insurers-ai-systems-causing-explosion-of-denials-warns-browns-public-health-dean.html.