Misleading marketing of non-ACA health plans continued during COVID-19 special enrollment period
- Collection:
- Health Policy and Services Research
- Author(s):
- Palanker, Dania, author Volk, JoAnn, author
- Contributor(s):
- Georgetown University. Health Policy Institute. Center on Health Insurance Reforms, issuing body.
- Publication:
- [Washington, D.C.] : Georgetown University Health Policy Institute, Center on Health Insurance Reforms, October 2021
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Health Insurance Exchanges Insurance, Health Marketing of Health Services COVID-19 Deception United States United States.
- Genre(s):
- Technical Report
- Abstract:
- Millions of Americans are eligible for health insurance plans with little or no premium and significantly reduced cost-sharing this coming open enrollment period thanks to historic enhanced marketplace subsidies under the American Rescue Plan (ARP). But a secret shopper study conducted during the recent COVID-19 special enrollment period suggests that some consumers shopping for coverage during the upcoming open enrollment period will likely be directed, by misleading marketing practices, to alternative plans without the protections of the ACA. These alternative plans--including fixed indemnity plans, short-term health plans, and health care sharing ministries--fail to protect people with preexisting conditions, exclude many essential health benefits, and leave enrollees vulnerable to catastrophic medical bills. Despite these gaps, enrollment in these types of products has increased in recent years, rising at least in part from deceptive and misleading marketing of these products to individuals who are searching for comprehensive major medical coverage. Several studies and investigations--including a 2019 Georgetown study, a year-long investigation by the House Energy and Commerce Committee, an undercover investigation by the U.S. Government Accountability Office, and secret shopper analysis by researchers at Brookings--have documented misleading or deceptive marketing practices associated with alternative plans. These analyses all reach similar conclusions--sales representatives often misrepresent the coverage to consumers, urge consumers to purchase plans over the phone without written information, or fail to disclose major coverage limitations, including limitations and coverage for COVID related services. Once enrolled in alternative plans, these limitations can leave consumers on the hook for their full medical bills. Preexisting condition exclusions have been found to leave consumers with tens of thousands of dollars in uncovered medical bills. Some alternative plans, including short-term plans, are known to rescind coverage--a practice where the insurer determines an enrollee has a preexisting condition after a medical claim is filed and uses that condition as justification to retroactively cancel coverage. To assess whether these practices have continued throughout 2021, this study replicated a prior secret shopper study from 2019. The goal of this study is to see if shoppers were still being directed towards alternative coverage at a time when the ACA coverage was broadly available and more affordable than ever because of the enhanced premium subsidies under the ARP. Findings. Despite the broad expansion of affordable coverage because of the change in federal policy, the results of this study largely mirrored the results from the 2019 Georgetown study and other studies. (1) Online consumers are still being directed to agents, brokers, or other sales representatives [herein representatives] selling, by phone, alternative coverage that costs more and covers less than the ACA plans available during the special enrollment period. Ten out of the top 12 search results directed consumers to websites that collected personal information that resulted in calls, emails, and text messages. Of phone calls with 20 representatives, only five recommended marketplace coverage. (2) Consumers were far more likely to be referred to fixed indemnity plans, health care sharing ministries, short-term plans, and other non-ACA products that were impossible to categorize based on the information provided. These alternative plans were typically more expensive than marketplace coverage and had higher cost-sharing. Representatives repeatedly provided misleading information about the alternative plans they were selling as well as false statements about the cost and features of marketplace plans.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-ND license. (More information)
- Extent:
- 1 online resource (1 PDF file (4 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918335064306676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918335064306676