It's not unusual that insurance companies would prefer that simpler and less expensive treatments be tried, before the more expensive ones are initiated... it's one method of holding the rising costs of health care down.
When I began to have trouble with my shoulder, the insurance company insisted on a period of physical therapy BEFORE resorting to an MRI, which made some sense.... the PT is comparatively cheap, while an MRI is expensive. However, when PT simply made my shoulder worse, they authorized the MRI, and the subsequent surgery (AND more PT afterwards). All of this was fine with me.
However, it doesn't always work to the benefit of the patient.
My new granddaughter, within a few days of birth, began to show evidence of a gastro-esophageal reflux problem. The best solution, according to the doctors, was a switch to smaller, more frequent feedings, as well as a switch to a special formula, available only by prescription, which is quite expensive.
The insurance company's judgment: the infant should attempt to be fed with three OTHER formulas, all far less expensive, first..... before they would authorize payment for the expensive stuff. In other words, they wanted the child to be the subject of a 'medical experiment' of sorts. Considering the fact that the symptoms of her problem were stopping breathing for 10-20 seconds at a time, this seemed damned unreasonable. My daughter is paying for the expensive formula, out of pocket, which could cost up to $6000 in the first year.
For all the talk of how the 'government' would get between a patient and their doctor with the AHCA, it seems that nobody realizes that this already occurs, and has been occurring for quite a while. Doctors all over the country tailor their treatment to the constraints of an insurance company's decisions about 'appropriate care'.
Would it be better, with the AHCA? Probably not a great deal. Would it be worse? I doubt it.