Florence Corcoran, an employee of South Central Bell Telephone Company, was eight months into a high-risk pregnancy when her obstetrician recommended she spend the final month on bed rest in the hospital, for close monitoring. Despite the recommendation, her health insurer determined that it would only cover partial-day at-home nursing care.

While a nurse was off duty, her fetus went into distress and died.

Corcoran sued her insurer, UnitedHealthcare. Because of a little-known law called the Employee Retirement and Income Security Act of 1974, or ERISA, she was unable to recover any money from her insurer due to their wrongful denial. She would see no legal justice following this avoidable tragedy.

Facing health insurance hurdles is an all-too-common American experience. But while courtroom dramas would have many Americans believe that patients can sue to recover money damages when they face wrongful denials, for most people who have employer-sponsored insurance, that is far from the truth. Corcoran’s case was decided in 1992 – and the situation is only worse today.

I’m a political scientist studying health insurance barriers and the politics of efforts to reform America’s health care system. In my book, “Coverage Denied: How Insurers Drive Inequality in the United States,” I traced how health insurance obstacles can upend patients’ health and economic lives.

ERISA magnifies those barriers by limiting patients’ legal ability to hold health insurers accountable – instead giving them a free pass to keep denying coverage without facing real consequences.

Healthcare rationing by inconvenience

Health insurance hurdles, such as prior authorization and claim denials, are widespread in U.S. healthcare, and the problem is growing.

Americans who have health insurance say prior authorization is the healthcare system’s biggest burden, causing administrative headaches while care is kept out of reach. Claim denials hit hard too.

Between 2016 and 2023,........

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