A health reform both parties can get behind

commentary Holding insurers accountable could be a point of agreement in a divided Washington Published October 8, 2026 9:00AM (EDT) (Getty Images / Boy_Anupong) We’ve spent our entire political careers in different camps. One of us was a Democratic governor and chairman of the Democratic National Committee. The other served as a conservative Republican in Congress for over a decade, representing a deep-red district in the Indiana heartland that President Donald Trump won in each of his three presidential elections by over 30 points. But before we got into politics, we were both physicians in internal medicine and cardiothoracic surgery, respectively. We’ve seen firsthand how crucial it is for the patient-provider relationship to guide and determine the right care. And that’s why we’re so alarmed that nearly half of Americans, according to a recent survey by KFF, the independent health organization, now report that their health insurers have delayed or denied coverage for a doctor-recommended treatment within the past two years. Corporate insurers should not be at the forefront of patient care. Delays and denials put patients’ health at risk. And they often lead to preventable complications and higher long-term spending. We both believe reforming the health insurance system is a moral and an economic imperative, as do many of our colleagues on both sides of the aisle. Even in a bitterly divided Congress, we have seen encouraging signs that reform is possible. In recent months, Democrats and Republicans have worked together to hold insurers accountable — especially when it comes to “prior authorization,” the notorious and widely despised insurer practice of denying certain procedures and treatments unless doctors and patients first obtain permission. In a recent American Medical Association survey, 95% of physicians said they’ve seen prior authorization requirements delay necessary care. Nearly four in five have witnessed patients abandon treatment because of problems with the process. Leaders in both parties already agree that improvements to the American insurance model are necessary. The bipartisan Improving Seniors’ Timely Access to Care Act would move Medicare Advantage prior authorizations to an electronic system and require quicker response times and greater transparency from insurers. Significantly, over 300 House members and 70 senators have cosponsored the legislation. This summer, it cleared two House committees unanimously. Want more sharp takes on politics? Sign up for our free newsletter, Standing Room Only, written by Amanda Marcotte, now also a weekly show on YouTube or wherever you get your podcasts. Lawmakers are also finding common ground on transparency. In July the House Energy and Commerce Committee advanced a bipartisan bill that would require health insurers to publicly report how often they deny claims. That scrutiny is overdue. Medicare Advantage insurers denied more than four million prior authorization requests in 2024. When patients and their doctors appealed those denials, insurance companies reversed roughly 80% of their initial decisions. That high reversal rate suggests insurers are denying lots of medically appropriate procedures, tests and treatments — and hoping that doctors and patients will be too busy, sick and frustrated to follow through with an appeal. That’s often a safe, albeit callous, bet. For too many Americans, fighting insurance companies can feel like a battle they cannot win. It often requires tremendous mental and emotional fortitude at a time when they are simply trying to get well. That is why Congress must take on that fight for them. Families already pay extraordinary sums for health coverage — by some measures, the monthly cost of employer-sponsored family health coverage now rivals the typical monthly mortgage payment. And still, these families face denials, delays and difficulty accessing the care and medicines they need. As physicians, we know that time matters when someone is sick. As a Democrat and a Republican, we also recognize how rare genuine consensus is in Washington. That’s why we’re cautiously hopeful that after the midterms, Congress will seize the opportunity to make prior authorization and broader insurance marketplace reforms a priority. Related Topics ------------------------------------------ Related Articles