Health insurers with many denied claims would pay refunds to customers.
This bill would make health insurance companies pay back customers if they deny too many claims. If an insurer denies 25% or more of claims, they could face large fines. This money would go directly to the people on those plans, starting with plans that begin on or after January 1, 2027.
Today, no federal rules fine health insurers for many denied claims. There are also no clear rules for them to provide full explanations for denials for claims not needed for health. Nor do they have to report their overall denial rates. If this bill passes, health insurers could face fines up to $10,000,000. They would pay this if they deny 25 percent or more of claims. An extra $2,000,000 would be added for every percentage point over 25% denied. This money would go to affected customers. Insurers would also have to give clear reasons for denials for claims not needed for health. And they would report their total denial rates to the government.
HR 8442 · 119th Congress · April 22, 2026 · AI Summary by gemini-2.5-flash · 10/10
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