The Cost of Crossing the Road

What's happening

Eric Tennant, a 58-year-old coal-mining safety instructor from West Virginia, died on September 17, 2025, after his insurer denied coverage four times for a $50,000 procedure his oncologist recommended to target a cancerous liver tumor. The treatment, histotripsy, cost less than the chemotherapy his insurance had already approved. The insurer, the West Virginia Public Employees Insurance Agency administered by UnitedHealthcare, called the procedure "not medically necessary" and "experimental and investigational." After journalists from KFF Health News and NBC News contacted the insurer, coverage was reversed in late May 2025. Within a week, Tennant was hospitalized. His cancer had spread beyond the point where the procedure was viable. He died at home in hospice three months later. Over 80% of denied prior authorization appeals nationwide were overturned between 2019 and 2024. The initial denial, in the majority of cases, is wrong.

What the Text says

James wrote his letter to scattered communities where laborers were being exploited by the wealthy. The passage is addressed not to the poor but to those withholding from them.

James 5:1-41Come now, you rich, weep and howl for your miseries that are coming on you.2Your riches are corrupted and your garments are moth-eaten.3Your gold and your silver are corroded, and their corrosion will be for a testimony against you, and will eat your flesh like fire. You have laid up your treasure in the last days.4Behold, the wages of the laborers who mowed your fields, which you have kept back by fraud, cry out, and the cries of those who reaped have entered into the ears of the Lord of Armies.

The Greek word translated "cries" is krauge, a raw, involuntary sound. It is not a petition. It is not an appeal filed through proper channels. It is the sound a person makes when the system designed to protect them becomes the instrument of their harm. James says that sound reaches the Lord of Armies.

The wages "kept back by fraud" in the original context were literal: landowners holding payment from field workers who had no legal recourse. James does not distinguish between active theft and structural withholding. The effect is identical. The laborer worked, the payment was owed, and the one who owed it found a mechanism to delay.

Eric Tennant paid his premiums for decades. His physician prescribed a treatment. The insurer owed a decision grounded in medical reality. Instead, four denials cycled through bureaucratic review while a tumor grew. James would not have recognized a distinction between the ancient fraud and the modern one.

The reflection

The histotripsy cost $50,000. The chemotherapy it would have replaced cost more. The law Tennant's death inspired will cost West Virginia $13 million per year. The math reveals what the denial letters obscured: this was never a medical judgment. It was a calculation that the cost of delay would be borne by someone else.

Becky Tennant told legislators, "You took that chance away from us." She was not asking for a miracle. She was asking for the procedure her husband's doctor prescribed and her husband's premiums had earned.

Some chances, once taken away, do not return.