Last Wednesday, Brian Thompson, the CEO of UnitedHealthcare, was tragically killed in midtown Manhattan in what authorities described as a “pre-meditated, preplanned, targeted attack.” Just days earlier, Anthem Blue Cross Blue Shield announced a policy limiting anesthesia coverage for surgeries exceeding a specified time limit in some states. However, backlash led to the swift reversal of this policy before its planned implementation in February.
These incidents have reignited public frustration with the American health insurance system, which operates through a mix of private insurance covering about 200 million Americans and government programs like Medicaid and Medicare. Most Americans access health insurance through their employers, directly purchase plans, or rely on government programs, but coverage remains costly. Even with insurance, expenses such as premiums, deductibles, and co-pays can be financially burdensome. Additionally, receiving care from out-of-network providers—often an unintentional consequence, such as in emergencies—can lead to astronomical bills.
One of the most pressing issues is insurers’ rejection of claims. Data from state and federal regulators show that one in seven claims is denied, and few people challenge these decisions. A study found that only 0.1% of denied claims under the Affordable Care Act are formally appealed, leaving many to pay out of pocket for care or forego treatment altogether. Medical debt remains the leading cause of bankruptcy in the United States, compounding the emotional toll of navigating a convoluted insurance system.
Thompson’s death and the Anthem policy controversy have sparked widespread criticism of the insurance industry, bringing personal stories of hardship to light. These narratives expose the frustration, heartbreak, and financial ruin many face while dealing with denied claims, delayed care, and insurmountable medical bills.
A Mother’s Desperate Fight
Jessica Alfano, a TikTok content creator known as @monetizationmom, shared her harrowing experience with UnitedHealthcare while her one-year-old daughter was hospitalized with a brain tumor. When her child required emergency surgery at a hospital outside their home state, UnitedHealthcare allegedly refused to approve an ambulance transfer to New York City. Adding to the distress, Alfano was informed that if she drove her daughter herself, insurance wouldn’t cover care at the new hospital. “I vividly remember being on the phone with UnitedHealthcare for days and days—nine months pregnant about to give birth alone—while my other baby was sitting in a hospital room,” she recalled.
The Cost of Misfortune
Allie, a TikTok user posting as @theseaowl44, described her experience of being in “excruciating pain” during pregnancy. Initially misdiagnosed with a urinary tract infection, she later discovered she had appendicitis and required emergency surgery at a larger hospital in St. Louis. Tragically, her son died the day after being born.
As if this wasn’t devastating enough, Allie suffered a pulmonary embolism and required emergency surgery to remove her placenta, nearly losing her life. She later learned that the hospital she was taken to by ambulance was out of network, leaving her with a bill larger than the cost of her home. “We opted to have to file bankruptcy, but not before I exhausted every appeal with Cigna,” she said. After pouring her heart into letters and phone calls, her final appeal was rejected. “Cigna’s appeal physician told me, point blank, it was my fault that when I was dying from a ruptured appendix in the ER, I didn’t check and make sure that the hospital I was being sent to by ambulance was in my insurance network.”
Heartbreaking Tales Across Social Media
Similar stories flood social media platforms, exposing systemic flaws in the insurance industry. One TikTok user, @ChickWithSticks, shared how insurance denied her new leg braces as a paraplegic and only approved a wheelchair. “They wanted to take my ability to WALK away,” she commented.
Another TikToker, Meagan Pitts, revealed that while her insurance covered her child’s NICU stay, it denied coverage for the neonatologists contracted by the NICU. “I’m sorry, what?” she questioned.
One mother recounted her son’s congenital heart defect and the denial of critical intervention by UnitedHealthcare after her husband switched jobs. “They DENIED my son’s cath lab intervention!” she wrote.
Hospital Discharge Nightmare
A Reddit user, @Sweet_Nature_7015, shared the trauma of a car accident involving her and her husband. While her husband was in a coma, their insurance, UnitedHealthcare, covered only two days in the hospital and attempted to discharge him prematurely. “The stress of being told—your health insurance isn’t covering this anymore, we have to discharge your husband—while he’s in a freaking coma and on a ventilator… I can’t even put into words how much stress UHC caused on top of my husband (and my) health issues in the most stressful time of my life.”
To secure continued care, she had to sign away her husband’s job-related benefits, including life insurance, so he could qualify for Medicaid. Years later, when the couple received a court settlement from the driver responsible for the accident, “UHC rolled up to the court and took the entire settlement money as their payment for those two days in the hospital they had paid for.”
“I’m One of the Lucky Ones”
Redditor @sebastorio recounted paying $1,400 out of pocket after UnitedHealthcare denied coverage for emergency care related to an eye injury that could have resulted in blindness. “I’m one of the lucky ones,” they wrote, expressing empathy for those facing even greater struggles for life-saving care.
Denied Coverage During Childbirth
Another Reddit user, @colonelcatsup, detailed their ordeal when their insurance switched to UnitedHealthcare at midnight as they were in premature labor. Their baby required weeks in the NICU, resulting in an $80,000 bill that UnitedHealthcare refused to cover. “In addition to dealing with a premature baby, I had a constant stream of hostile collection calls and mail from the hospital for 18 months. My credit took a hit,” they wrote.
An attorney hired by their employer eventually secured payment from UnitedHealthcare, but the stress lingered. “I will never forgive them for the added stress hanging over me for the first year and a half of my child’s life.”
Debt or Death
Author Bess Kalb shared her story on Substack, recounting a frightening moment when she was bleeding during pregnancy and the EMT hesitated, asking about her insurance before deciding whether to take her to the nearest hospital. The hospital bill ultimately exceeded $10,000.
“The private insurance industry forces millions of Americans to choose between debt or death,” Kalb wrote. “Often, ghoulishly, the outcome is both. If I were worried about an ambulance out of coverage, I would have waited at home… perhaps would not be here to write this, and neither would my son.”
A Broken System
These stories, coupled with public outrage, reflect a common sentiment: the U.S. health insurance system often fails the very people it is meant to protect. Whether through denied claims, overwhelming medical debt, or bureaucratic hurdles, Americans are frequently forced to endure emotional, financial, and physical suffering. The pervasive issue of balancing life-saving care against unaffordable costs highlights the urgent need for systemic reform.