Health Insurance Disparities Exacerbated by Lack of Clout

Low-income patients and their healthcare providers are more likely to face denial of their health insurance claims, particularly for preventive care and medical services, due to bureaucratic and systemic barriers. These disparities are further exacerbated by the lack of clemency in contesting these denials, with low-income patients and marginalized groups facing significant challenges in getting their claims reversed.

Key Takeaways:

• Low-income patients are 43% more likely to have their health insurance claims denied for preventive care compared to high-income patients (Horny et al., 2025)
• Historically marginalized racial and ethnic groups are roughly twice as likely as non-Hispanic whites to incur denials (Horny et al., 2025)
• Low-income patients are less likely to contest denied claims, with only 22% of denied claims being challenged (Horny et al., 2025)
• When low-income patients and marginalized groups do contest denied claims, they are more likely to be successful than non-Hispanic whites, but the mean reduction in cost-sharing is lower among Black and Hispanic people than among whites (Horny et al., 2025)
• Healthcare providers play a significant role in contesting denied claims, with inadvertently billed patients often being easier to reverse than intentionally billed patients (Horny, 2025)
• The lack of flexibility in low-income patients' jobs and lives makes it difficult for them to spend hours on the phone contesting denied claims (Horny, 2025)
• Regulators need to demand health insurance companies to be more user-friendly, allowing people to contest claims online 24/7 (Horny, 2025)
• Universal billing codes among payers could simplify the claims process and reduce errors by both providers and insurers (Horny, 2025)

Statistics:

• 43% increase in denial rates for preventive care in low-income patients compared to high-income patients (Horny et al., 2025)
• 2 in 5 denials result from incorrect billing by healthcare providers or processing errors by health insurers (Horny et al., 2025)
• 51,299 denied claims of medical services provided to U.S. adults with private health insurance between 2017 and 2019 (Horny et al., 2025)
• 22% of denied claims being challenged by low-income patients (Horny et al., 2025)
• $x reduction in cost-sharing among Black and Hispanic people compared to non-Hispanic whites (Horny et al., 2025)

Sources:

• Horny, M. et al. (2025). Disparities in contested claims denials. Health Affairs.
• Horny, M. (2025). Low-income patients face greater barriers in contesting denied claims. JAMA Network Open.
• NewsRx LLC. (2025). Health Insurance Disparities Exacerbated by Lack of Clout. VerticalNews.