Don’t fault insurers for greed — it’s the government’s mishandling of healthcare that’s to blame.

Many are pointing fingers at the greed of health insurance companies for the escalating costs, increased claim denials, and significant barriers to care.

This perspective is shortsighted.

To uncover the genuine offenders, look at the deceitful politicians.

According to the American Medical Association, insurers denied about 1.5% of claims in 2013, prior to the enactment of the Affordable Care Act (ACA) regulations.

However, under the ACA, denials surged tenfold.

Currently, approximately 15% of claims are denied, as reported by Premier, an insurance consulting firm.

Some insurers are rejecting a third or more of claims, according to research from the Kaiser Family Foundation.

Insurers are also increasingly requiring pre-authorization for a broad array of treatments and medications, placing restrictions on your doctor and potentially delaying critical care.

Your physician often must contact the insurer before commencing treatment or prescribing a medication—and the person on the line frequently lacks expertise in the specific disease or treatment.

It could even be an ob/gyn overruling your neurosurgeon’s recommendations, as cautioned by the AMA.

Dr. Debra Patt, an oncologist in Austin, Texas, shared with the AMA that she prescribed a drug combination for a patient battling metastatic breast cancer, but had to endure weeks waiting for pre-authorization.

During this time, she was forced to rely on standard chemotherapy, which was inadequate for her patient’s needs.

Tragically, her patient did not survive.

“You have health plan representatives who have never met the patient, have never been at the bedside, or practiced medicine, yet they are making treatment decisions,” contends Tina Grant from Trinity Health, a national network of 27 Catholic hospitals.

Furthermore, testimony from the House Committee on Energy and Commerce revealed that 80% of pre-approvals denied by Cigna for Medicare Advantage recipients were later overturned upon appeal—indicating that necessary care is being withheld.

Cigna employs an algorithm known as PXDX to deny prior authorizations in bulk.

Since the ACA was implemented, denials and pre-authorization requests have been on the rise.

However, it’s not just about profit motive: The law imposes regulations and limitations on profits derived from health policies.

Underwriting profits are assessed through the “medical loss ratio,” which measures the percentage of premium revenue allocated to healthcare.

(The industry considers that expenditure a “loss.”)

The ACA mandates that individual and small-group plans allocate 80% towards care, with large plans required to spend 85%.

If an insurer fails to meet these thresholds and generates excessive profits, they are obligated to provide a rebate to policyholders.

Major players like United Healthcare have expanded into lucrative entities not solely by marketing health plans but by acquiring hospitals, physicians’ practices, and pharmacy chains, as demonstrated by IBIS industry research.

The true issue behind the decreasing reliability of your health insurance lies in this: The politicians who supported Obamacare made unrealistic promises that could only be fulfilled by insurers resorting to predatory practices.

Advocates of Obamacare claimed everyone would be charged equally, regardless of their “pre-existing conditions.”

However, this is mathematically impossible: Annually, only 5% of the population is accountable for over 50% of healthcare expenditures.

That’s a hard truth, regardless of political sentiment.

Attempting to have insurers cover the unhealthy 5% at the same rates as healthier individuals is akin to trying to budget the same for groceries for a slim fashion model and a Nathan’s hot-dog-eating champion.

Absurd.

The federal government could have intervened by providing additional financial support to assist individuals with pre-existing conditions.

Instead, insurers were inundated with a surge of new claims and instructed to make it work.

And they did—by implementing harsh cost-reduction strategies.

The beneficiaries?

Democratic politicians.

Offering coverage for pre-existing conditions at no additional visible cost is a favorable stance.

The victims? 

Everyone else, who now faces potential delays in treatment or claim denials.

The most adversely affected are the seriously ill individuals—who bear a disproportionate burden from the restrictive controls of managed care, as indicated by the National Bureau of Economic Research.

Many states are currently enacting legislation to restrict prior authorization requirements.

This is a positive development.

However, Americans need to reevaluate managed care: There is minimal evidence to suggest it enhances health outcomes.

President Biden’s Department of Health and Human Services has claimed that the ACA’s expansion of coverage—mainly through managed care—has led to decreased “morbidity and mortality.”

This is a blatant falsehood.

Today, Americans are less healthy and facing shorter life expectancies than prior to the ACA’s implementation.

One potential solution: Introduce affordable catastrophic insurance, which activates only for significant medical costs.

Healthy individuals who receive insurance through their employment could pay out-of-pocket for routine healthcare.

This would allow them to engage less with insurers and enjoy higher take-home pay, rather than paying a staggering average of $25,000 for family coverage this year.

Democrats attempt to label catastrophic coverage as “junk insurance.”

The Biden administration has made it nearly impossible to acquire.

Yet, as more Americans recognize, health plans that deny legitimate claims and necessitate perilously lengthy waits for pre-authorization are the true form of “junk.”

Betsy McCaughey is a former lieutenant governor of New York and co-founder of the Committee to Save Our City.