Chief Executive Officer & Non-Independent Non-Executive Chairman, UnitedHealth Group
Barragan Pulls Up UnitedHealth Group's Claim Denial Rates To CEO's Face—Then A Testy Exchange Ensues
During a House Energy and Commerce Committee hearing in January, Rep. Nanette Barragan (D-CA) grilled UnitedHealth Group CEO Stephen Hemsley over his company's denial rates.
Stay Connected
Forbes Breaking News on X: https://x.com/ForbesTVNews
Forbes Breaking News on TikTok: / forbestvnews
More From Forbes: http://forbes.com
About Stephen Hemsley
On UnitedHealth Group’s second quarter 2026 earnings call, Stephen Hemsley stated that the company’s results and updated full-year outlook reflect “continuing progress toward delivering more consistent and dependable performance” and “stronger broad-based performance disciplines taking hold in each of our businesses.” He attributed the improvement to positive claims experience, a lighter flu and respiratory season, and targeted actions including benefit design, network curation, and investments in value-based care. Hemsley noted that medical trends remain “well above historical levels” and said the company is “intensely focused on affordability” given the elevated trend. Hemsley also described the company’s commitment to “making the health system work better for all stakeholders” through simplification, consistency, and modernization of the customer experience. He cited the use of AI technology to “improve service interactions, reduce administrative burden, and support better decision-making.” Regarding the 2027 outlook, Hemsley said it was “still a little bit too early to talk a lot of specifics,” but that the company plans “reflective of our current experience” and does not expect “a meaningful deviation from the still elevated underlying core trends.”
Transcript (25 segments)
C
Chairman0:00
California, Miss Baragon for her five minutes of questioning.
M
Miss Baragon0:03
Thank you, Mr. Chairman. I want to just ask the witnesses, all of you here except the witness on the end. All of you get a stock option or a stock benefit for your compensation. Is that correct, Mr. Hemsley?
S
Stephen Hemsley0:18
Yes, Representative.
M
Miss Baragon0:19
And Mr. Joiner.
M
Mr. Joiner0:20
Yes.
M
Miss Baragon0:21
Miss...
W
Witness0:23
I do as well, tied to long-term incentives.
M
Miss Baragon0:25
Okay. And...
W
Witness0:27
Yes, I do. No, we don't have any ownership or stock. We're a nonprofit. There's no ownership.
M
Miss Baragon0:33
Okay. You get... Oh, you get performance bonuses instead.
W
Witness0:36
Correct.
M
Miss Baragon0:37
Okay. So, those of you who have stock, your company has to do better or good for you to maintain that value in that stock. Is that right? Nobody disagrees with that, right? You're all in the business of making a profit, right? Nobody disagrees with that. Okay. Mr. Hemsley, you got a $60 million onetime equity award. That's a lot of money for my constituents. When I said we were having this hearing today, I said, 'What would you ask?' They said, 'We want to know why they're making so much and why we can't afford our health care or why we stretch every penny and dime to buy health care just to have the claim denied when I actually need it.' And that's what's wrong. That is what's wrong in this system. Mr. Hemsley, you were just asked about the denial rates. I have a chart. I have a chart right here of the denial rates. I don't know if you could see it, but UnitedHealthcare Group, according to the Kaiser Family Foundation study, says your in-network denial rate is 33%. That's 33%. You just told my colleague that was inaccurate. Are you saying the report is inaccurate? Are you just not aware of what your denial rates are?
S
Stephen Hemsley2:19
Representative, I think we are aware of our denial rates. I don't know the context of what you're showing me.
M
Miss Baragon2:25
Okay. So, you're not aware of the study. Okay. What do you think your denial rate is? What do you think the percentage is?
S
Stephen Hemsley2:31
Yeah, we're having a hard time hearing. If you could pull your mic closer and we'll give you next seconds.
M
Miss Baragon2:35
Okay. What do you think your denial rate is?
S
Stephen Hemsley2:39
Less than 2%. Yeah, that's like wildly off from any numbers that I have seen.
M
Miss Baragon2:44
I want to enter into the record an LA Times article published in February 2025 that tells the story of Colleen Henderson and her three-year-old toddler, who of course is insured by UnitedHealthcare. They fought your company for five years to pay for specialty care to treat their three-year-old daughter's rare condition. She had a tumor in her bladder. A tumor in her bladder. The family ended up with a million dollars in medical debt and was forced to declare bankruptcy because UnitedHealthcare said treatments recommended by the doctors were unnecessary. Do you understand why the American people are not a fan of UnitedHealthcare and big healthcare companies? Mr. Hemsley.
S
Stephen Hemsley3:32
I think that is a tragic situation. I don't know the details of it, but I'm very sympathetic to situations like that.
M
Miss Baragon3:40
Well, what are you going to do to make sure that more families are not going into medical debt and that their kids can get the care they need because you know the alternative is the kid is going to die.
S
Stephen Hemsley3:49
Well, I'm glad you brought that up because I think one of the reasons that motivated me to return to this company is because I think we could be a force for solutions like that and that our mission aligns to that and my purpose is to improve the performance of this enterprise to solve those kinds of solutions.
M
Miss Baragon4:09
Well, I hope that we see improvements and I'm going to be tracking that progress to see if it actually happens. The other thing that's really quite fascinating is that we find that most people will not appeal these denials. Most people don't have the time or the effort. I live in a district where it's working-class families. They can barely find the time to show up to two jobs to pay their bills. You think they're going to have the time and the effort to appeal a claim? We've seen that less than 1% of claims are appealed, but when they are, insurance reverse their decision 44% of the time. That's almost half. Why do your patients have to fight your company to get their claims covered?
S
Stephen Hemsley4:51
Representative, again, I appreciate the subject. It's important. They shouldn't have to fight. We should make this much easier and intuitive and we use technology for that purpose. We have a number of initiatives in market right now.
M
Miss Baragon5:05
Mr. Hemsley, try to make it real. The way you're talking about this is not sympathetic. It's not compassionate. I appreciate the topic. These are people's lives. These are children's lives. This is when people... You said that you want to help people when they're sick. You know what doesn't help? When they get a bill or they have to go into medical debt for a million dollars of debt. That doesn't help people when they're sick. I hope that you all are going to do better.
C
Chairman5:29
The gentle lady yields back. And the gentle lady referenced a document. If she can make sure we have a copy of that. And without objection, it is so ordered to be entered into the record.