ERs Become the Default Clinic: The Cost of Insurance Roadblocks

Emergency rooms are increasingly becoming America’s “front door” to healthcare, not only for accidents or life-threatening issues, but also for patients with urgent non-emergency needs. A big reason is insurance denials. Insurers often block or delay routine tests and treatments, forcing patients into the ER, where care is immediate but far more expensive.

Prior authorization — where a doctor must get insurer approval before ordering tests or treatments — was meant to prevent unnecessary care. Instead, it has turned into a paperwork obstacle course that delays needed treatment and raises costs. Reports show that some insurers spend barely over a second reviewing cases, with hundreds of thousands of claims mass-denied. Medicaid patients are especially vulnerable, with one in four requests going unanswered, often pushing them into ER visits within weeks.

This system leaves families with crushing medical debt, now a leading cause of bankruptcy in the U.S. Some patients have managed to fight denials using social media pressure, but real solutions require change. Experts call for transparency, fair appeals, and government guardrails. Until insurers stop prioritizing denials over care, men and their families will continue to face unnecessary suffering, costs, and delays in getting the help they need.

Cozzi, N., & Shoemaker, J. (2025, September 25). Why patients are flooding emergency rooms. TIME. https://time.com/7319387/health-insurance-us-emergency-room-prior-authorization/?utm_source=beehiiv&utm_medium=email&utm_campaign=newsletter-daily-spotlight&_bhlid=fd233ea1726851f66e72b331a9a6497b4281556a