Brian Thompson, the CEO of UnitedHealthcare, was tragically shot and killed in midtown Manhattan on Wednesday in what police describe as a “pre-meditated, preplanned, targeted attack.” Days earlier, Anthem Blue Cross Blue Shield faced backlash after announcing a policy to limit anesthesia coverage for surgeries exceeding a set duration in certain states—a decision quickly reversed following public outrage. These incidents have reignited debates about the deep-seated issues within the U.S. health insurance system.
In the United States, health coverage primarily depends on private insurers and government-run programs, collectively covering around 200 million Americans. Individuals typically receive insurance through employers, government initiatives like Medicaid or Medicare, or by purchasing private plans, often at steep costs. Despite having insurance, medical expenses can remain burdensome, with premiums, co-pays, and deductibles adding up. Additionally, unexpected medical scenarios, such as being taken to an out-of-network hospital by ambulance, can lead to astronomical bills.
Compounding these issues is the fact that insurers reject about one in seven treatment claims, according to data from state and federal regulators. Many patients accept these denials without contest, as a study reveals that only 0.1% of denied claims under the Affordable Care Act are formally appealed. This law was designed to enhance the affordability of insurance and prevent discrimination against pre-existing conditions, yet the reality leaves many paying out of pocket or forgoing necessary care altogether.
The emotional and financial toll of navigating this complex system is immense. For many, medical debt is the leading cause of bankruptcy in the U.S. The murder of Thompson and the outcry over Anthem’s proposed policy have spurred widespread criticism, particularly among individuals recounting personal struggles with the insurance system.
Jessica Alfano, a content creator known as @monetizationmom on TikTok, shared her harrowing experience battling UnitedHealthcare while her one-year-old child was hospitalized with a brain tumor. Her daughter required emergency surgery at a specialized hospital in New York City, but UnitedHealthcare allegedly refused to authorize the ambulance transfer. Alfano, nine months pregnant at the time, was told that if she transported her daughter without ambulance authorization, coverage at the destination hospital would be denied. “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 recounted.
Allie, another TikToker who posts as @theseaowl44, shared her devastating ordeal. While pregnant, she visited the hospital in severe pain and was initially misdiagnosed with a urinary tract infection. When her condition worsened, she was diagnosed with appendicitis and rushed to a larger hospital for emergency surgery. Although her son survived the operation, he tragically passed away the next day after delivery. Soon after, Allie herself suffered a pulmonary embolism and required emergency procedures to save her life.
To her shock, she later discovered the hospital was out of her insurance network. “We ended up with a bill from the hospital that was more than what we paid for the home that we live in,” Allie said. After exhausting every appeal with her insurer, Cigna, she was forced to declare bankruptcy. Reflecting on her third and final appeal, she shared, “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.”
Such stories are distressingly common. One TikTok commenter, @ChickWithSticks, recounted that despite being a paraplegic who relies on leg braces and crutches, their insurer attempted to deny new leg braces and only approved a wheelchair. “They wanted to take my ability to WALK away,” they wrote. Another user, Meagan Pitts, shared how her insurance covered her newborn’s NICU stay but denied the neonatologist’s services. “I’m sorry, what?” she asked incredulously.
A Redditor, @Sweet_Nature_7015, described their battle with UnitedHealthcare after a severe car accident left their husband in a coma. The insurer initially covered only two days of hospitalization and pressured the family to discharge the patient 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, etc., ridiculous,” they wrote. Years later, after winning a court settlement against the driver responsible for the accident, UnitedHealthcare seized the entire settlement as reimbursement for the limited coverage it had provided.
In another account, Redditor @sebastorio visited the emergency room for a serious eye injury, only to have UnitedHealthcare deny the claim. “I paid $1,400 out of pocket,” they said, adding, “I’m one of the lucky ones. Can’t imagine how people would feel if that happened for critical or life-saving care.”
The frustration extends to maternity care as well. Redditor @colonelcatsup faced a bureaucratic nightmare when premature labor coincided with an insurance transition from one company to UnitedHealthcare. The insurer refused to cover the over $80,000 NICU bill, claiming it was not their responsibility. The resulting barrage of collection calls and mail added enormous stress during an already difficult time. “My credit took a hit,” they shared, adding that only the intervention of their employer’s attorney compelled UnitedHealthcare to pay. “I will never forgive them for the added stress hanging over me for the first year and a half of my child’s life.”
Author Bess Kalb detailed her own ordeal in a Substack post, recalling an incident during her pregnancy when she was bleeding heavily. An EMT hesitated to transport her to the nearest hospital until confirming her insurance coverage. Kalb and her husband chose to proceed despite the uncertainty, resulting in a bill exceeding $10,000. She condemned the insurance industry for forcing people into impossible choices. “The private insurance industry forces millions of Americans to choose between debt or death,” Kalb wrote. “Often, ghoulishly, the outcome is both.”
These stories underscore the human cost of the dysfunctional U.S. insurance system. Whether it’s battling denied claims, facing insurmountable debt, or enduring the emotional toll of bureaucratic hurdles during medical emergencies, millions of Americans are left vulnerable. The killing of Thompson and the uproar over Anthem’s brief policy change have shone a spotlight on a broken system, but the personal accounts of those affected reveal the depth of the crisis. For many, the question remains: when will substantive change come?
