Watch OVERTURNED: The just-released mini documentary about Denial of Care Harm-for-Profit and the Threats Commercial Health Insurance Companies Make to Keep Ethical Medical Professionals Quiet
Photography by Ashley Gilbertson | Edited by Julie Winokur | Co-published in Partnership with Wendell Potter and Health Care un-Covered | December 16, 2024
Watch > OVERTURNED
Every day, far too many Americans need to navigate a hostile commercial health insurance landscape to get the medical care and medicines that their doctors say they need.
As HEALTH CARE un-covered published previously, for eight grueling months, Jennifer Braunagel endured debilitating pain from rheumatoid arthritis while her insurance company, Aetna, denied coverage for Actemra, the only medication that offered hope. Her struggles were both emotional and physical – confronting endless roadblocks like prior authorization and step therapy, tactics big health insurers like Aetna, Cigna and UnitedHealth use to cut costs at patients’ expense.
“A 2023 survey by the health site KFF found that roughly six out of 10 patients reported an issue with a commercial health insurance claim – often during the process known as “prior authorization,” when a commercial health insurance company like Braunagel’s carrier, Aetna subsidiary Meritain Health, must approve a medical procedure or a new drug treatment ahead of time. The vast majority of patients whose requests for approval are rejected don’t file a formal appeal, either because they don’t understand their right to do so, don’t feel well enough to fight a denial, or just think it would be too time-consuming or futile to even try.”
—Wendell Potter
Braunagel’s breakthrough came through a startup called Claimable, which uses AI to streamline and supercharge the appeals process. By leveraging data from similar cases and highlighting violations of insurance guidelines, Claimable crafted an appeal that succeeded where traditional methods failed. Within days Braunagel’s insurer was forced to cover her medicine. The results were life-changing — Braunagel experienced dramatic relief after her first infusion.
This mini documentary, “Overturned,” with photography by Ashley Gilbertson and edited by Julie Winokur of Talking Eyes Media, features Braunagel’s story, her arthritis clinic’s tireless advocacy, and interviews with other patients, who are navigating systemic health care barriers and denials by big commercial health insurers.
ENGAGE and ACT NOW
What Americans Can Do Now to End Denial of Care Harm-for-Profit.
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