HARRISBURG, PA — Pennsylvania lawmakers have introduced legislation that would create criminal penalties for health insurance company chief executive officers when coverage denials for medically necessary care allegedly result in serious injury or death, escalating a growing debate over accountability in healthcare decision-making.
House Bill 2611, introduced this week by state Reps. Chris Pielli, D-Chester, and Emily Kinkead, D-Allegheny, would establish a new category of aggravated assault applicable to insurance company CEOs under specific circumstances involving adverse benefit determinations.
The proposal would apply when a covered individual suffers serious bodily injury or dies because of a denial involving a medically necessary service, according to the bill’s sponsors.
The legislation targets executive accountability within the insurance industry and reflects broader concerns about the role insurers play in determining access to medical treatment.
“Our healthcare system should prioritize patients, not profits,” Kinkead said. “When insurance executives — rather than treating medical professionals — determine patient care, and a decision to deny care leads to serious harm or death, there must be accountability.”
Supporters argue the measure would discourage decisions driven by financial considerations rather than medical necessity.
“Health insurance companies should not be making healthcare decisions without accountability,” Friel said. “We have an obligation to remove profit incentives from decisions to deny care — decisions that should be driven by medical necessity, not financial considerations.”
The lawmakers cited data from the Pennsylvania Insurance Department showing that individual-market qualified health plans denied more than 3 million claims in Pennsylvania during 2024.
The bill’s introduction comes amid heightened scrutiny of insurance coverage practices nationwide, as policymakers and consumer advocates continue to examine the impact of claim denials on patient outcomes and healthcare access.
House Bill 2611 has been referred to the Pennsylvania House Judiciary Committee for consideration.
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