(Los Angeles Times/Getty Images)
The healthcare system has arguably become the United States’ most heated policy battleground in recent months. The Luigi Mangione saga and its aftermath placed healthcare squarely at the forefront of national political discourse, reigniting public anger about the basic (and absurd) question of whether people should be able to afford staying alive.
California Assembly Bill 716 hasn’t gotten much national coverage, but it’s a striking case study in how the for-profit healthcare model disguises dysfunction as reform. It exemplifies how attempts to “fix” a broken system rarely question the system itself, they just smooth over its sharpest edges to maintain profit. In this case, it’s a neat trick: a law designed to “protect” patients from surprise ambulance billing, which in practice ends up punishing those with insurance.
I came across a video on Instagram posted by Robby Witt, an actor and content creator that occasionally publishes media breaking down complex consumer issues. In it, he’s on the phone with a healthcare insurance representative, trying to understand why his ambulance bill increased after his insurance was applied. Initially, Witt’s ambulance ride cost around $600. But after providing his insurance details, the total due ballooned to nearly $1,300. Rightfully baffled, Witt called the insurance company to ask why he was paying more for being insured.
The representative calmly explained: the actual cost of the ambulance was over $2,300. Because Witt was insured, the bill went through a contracted insurance adjustment, which meant the insurer covered only around $1,000, leaving him to pay the remaining $1,300. An uninsured person, on the other hand, would have automatically qualified for a discount, reducing their bill to around $600. Witt, stunned, asked plainly: “So I pay more with insurance than I would without it?” He followed it up with a more alarming question: “Should I cancel my insurance to pay less?”
His tone stayed dry and composed throughout, but the exchange felt like a live performance of American policy absurdism. It wasn’t just the story that shocked people, it was how calmly normalized it all seemed to the person explaining it.
The representative cited California Assembly Bill 716 as the reason for this counterintuitive billing logic. The law, which went into effect on January 1, 2024, was designed to end surprise billing for ground ambulance services. The headline promise was patient protection, shielding Californians from financial ruin after calling 911. In theory, AB716 ensures that insured patients only pay the in-network cost-sharing amount for ambulance services, even if the ambulance company is out-of-network. Insurers are supposed to cover the difference between that and the “reasonable” local rate.
It sounds like progress. And in some ways, it is: patients are no longer vulnerable to collections, credit damage, or bankruptcy from a single ambulance ride. For the uninsured, the law guarantees they’ll be charged the Medicare or Medi-Cal rate, usually the lowest baseline possible.
But in many cases, especially in cities like Los Angeles where ambulance providers are privatized and operate outside standard networks, insurance companies negotiate bizarre reimbursement rates that leave patients with higher out-of-pocket costs than if they had no insurance at all. The logic flips: the insured become the overcharged.
Which raises a deeper question: if having insurance actually makes you more financially vulnerable in emergency situations, what exactly is the product you’re buying?
That’s where AB716 becomes something more troubling than a flawed bill, it becomes a case of health-washing. That is, a policy marketed as reform, but which ultimately preserves the financial relationships between insurers, providers, and private equity at the expense of the patient. It gives lawmakers a win to campaign on, without doing the more politically risky work of breaking with the for-profit model itself.
This isn’t new. It’s part of a long pattern where incremental “fixes” are applied to a structurally exploitative healthcare system: patches that protect capital while selling the illusion of consumer rights. In this case, the illusion is that insurance equals protection. But for patients like Witt, the protection may seem more like a trap.
Realizing this can be just as damaging mentally as it is financially, it’s confusing and discouraging. People are told that getting insurance is the responsible thing to do — a basic step toward stability and security. But when following that advice leads to higher costs, it undermines trust in the system and sends a clear message: doing everything right doesn’t protect you. In some cases, it actually makes things worse, and you’re punished for participating in the system at all.
If more people start to realize they’re financially better off without insurance, it poses an existential threat not just to the healthcare industry, but to the political class that has built careers defending it. Laws like AB716 are meant to defuse that threat, to make the system seem just tolerable enough to endure. But the cracks are showing.
Witt’s story didn’t go viral just because it was shocking. It went viral because it was familiar.
SOCIO. 
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