Luigi Mangione Initiative Targets Insurance Denials In CA, Banning 'Delay, Deny' Tactics

CALIFORNIA — A proposed California ballot initiative to ensure more reliable health insurance coverage has been submitted to the California Attorney General’s Office, according to reports.

The initiative, named after alleged UnitedHealthcare CEO killer Luigi Mangione, would make it illegal for an insurance company to “delay, deny or modify any medical procedure or medication” suggested by a licensed California physician, if such a decision results in “disability, death, amputation, permanent disfigurement, loss or reduction of any bodily function.”

The initiative is named after Mangione because the words “delay,” “deny,” and “depose” were found on shell casings and a bullet at the scene of UnitedHealthcare CEO Brian Thompson’s shooting.

“Delay,” “deny,” and “depose,” detail how the insurance industry avoids paying out claims.

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If the initiative passes, insurers would no longer be allowed to use these tactics to avoid paying claims towards procedures or medications prescribed by a licensed California physician if such a decision results in serious harm to the patient. Additionally, any decision to delay, deny, or modify any such procedure or medication must be made by a physician, rather than an employee at an insurance company.

The initiative would also make it a felony for anyone who is not a licensed physician to make decisions about rejecting claims. No such law currently exists anywhere in the United States.

If claims are still delayed, denied, or modified, the initiative would place the burden on insurance companies to prove that they are unnecessary, and would not result in death, disability, or other serious consequences. If they cannot, the insurance companies would be liable for triple the damages, as well as attorney fees.

The Attorney General’s Office is currently reviewing the initiative, according to KRON4. Public comment opens April 25. The Attorney General’s Office would then craft the initiative’s final title before petitions are circulated to get signatures from registered voters.

To get on the ballot in California, a statutory initiative requires signatures from 5% of the number of voters in the most recent gubernatorial election. That would require 546,651 valid signatures to get on the ballot in November 2026.

See here to learn more about the law.