People gathered outside the Blair County courthouse for Luigi Mangione hearings on Dec. 19, 2024.
Sacramento, California – A newly proposed California ballot initiative, named after alleged UnitedHealthcare CEO killer Luigi Mangione, aims to drastically reshape how insurance companies handle medical treatment decisions in the state.
The initiative, recently submitted to the California Attorney General’s Office, would make it illegal for insurance companies to “delay, deny, or modify any medical procedure or medication” recommended by a licensed physician if doing so could lead to serious consequences such as disability, death, amputation, permanent disfigurement, or loss of bodily function.
If enacted, only a licensed physician—acting on behalf of an insurer—would be allowed to make decisions regarding treatment approvals. Additionally, the initiative would criminalize the employment of non-physicians to review physician-recommended treatments, making it a felony offense.
Under the proposal, if an insurance company delays a treatment, it would bear the legal burden of proving with “clear and convincing evidence” that the medication or procedure was unnecessary or would not result in harm if postponed. The initiative would also grant Californians the right to sue insurers and receive attorney fees along with treble damages—three times the amount of actual damages determined by a jury.
The initiative is currently under review, and the Attorney General’s Office has opened a public comment period that will run through April 25. During this time, Californians can provide feedback on the proposed measure. Once the review process is complete, the Attorney General’s Office will finalize the initiative’s title before petitions can be circulated to collect signatures from registered voters.
The proposal comes amid heightened public scrutiny of the insurance industry, following the high-profile murder of UnitedHealthcare CEO Andrew Witty. Mangione, the accused killer, reportedly harbored resentment toward insurance companies over denied medical care, fueling debate over insurer accountability.
Advocates of the measure argue that it would prevent insurers from making life-altering decisions without proper medical oversight, ensuring that healthcare remains in the hands of doctors rather than corporate administrators. However, critics warn that the initiative could lead to skyrocketing insurance costs and increased litigation, potentially straining the state’s healthcare system.
As the public comment period progresses, the proposal is expected to draw significant debate from healthcare professionals, insurers, and patient advocacy groups. If it gains enough support to qualify for the ballot, Californians could have the chance to vote on one of the most sweeping healthcare reforms in state history.
