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It should come as no surprise that the Trump administration has made enabling predatory actions by bad actors and promoting junk insurance the centerpiece of its health care agenda, such as it is. Junk plans--"short term" health plans, despite the fact that they're now available for the entire year--are on the verge of becoming a bonanza for hucksters no longer bound by consumer protection rules.
Think of these plans as the Trump University of health insurance. Beyond failing to offer the basic protections and coverage people have come to expect in the age of the ACA (pre-existing condition protections, no caps or limits, etc), short term plans on average spend an absurdly low 39 cents of every premium dollar they collect on actual medical care. By contrast, ACA-compliant plans are legally required to dedicate at least 80-85% of premiums on actual care.
Health Insurance That Doesn’t Cover the Bills Has Flooded the Market Under Trump
"Grifters gonna grift" remains the guiding philosophy of policy coming out of this administration.
Think of these plans as the Trump University of health insurance. Beyond failing to offer the basic protections and coverage people have come to expect in the age of the ACA (pre-existing condition protections, no caps or limits, etc), short term plans on average spend an absurdly low 39 cents of every premium dollar they collect on actual medical care. By contrast, ACA-compliant plans are legally required to dedicate at least 80-85% of premiums on actual care.
Health Insurance That Doesn’t Cover the Bills Has Flooded the Market Under Trump
Fewer than 100,000 people had such plans at the end of last year, according to state insurance regulators, but the Trump administration says that number will jump by 600,000 in 2019 as a result of the changes. Some brokers are taking advantage, selling plans so skimpy that they offer no meaningful coverage. And Health Insurance Innovations is at the center of the market. In interviews, lawsuits, and complaints to regulators, dozens of its customers say they were tricked into buying plans they didn’t realize were substandard until they were stuck with surprise bills. The company denies responsibility for any such incidents, saying it’s a technology platform that helps people find affordable policies through reputable agents.
Marisia soon learned about the policy’s limitations. The Everest plan didn’t cover preexisting conditions, limited the number of doctor visits, and capped hospital coverage at $1,000 a day. It allowed a maximum of $250 per emergency room visit and $5,000 per surgery, not nearly enough to cover the usual cost of those services. Most benefits didn’t kick in until the $7,500 deductible was met. And the listed maximum total payout of $750,000 was misleading: It didn’t mean the Diazes’ bills would be covered up to that amount after they paid the deductible; it just meant that if Marisia underwent, say, 150 surgeries, she could get $5,000 for each, leaving her to cover millions of dollars in additional bills.
Similar stories aren’t hard to find. Complaints to the Federal Trade Commission obtained by Businessweek via the Freedom of Information Act detail numerous cases of HIIQ customers buying medical insurance they believed was comprehensive, then having their claims rejected or barely paid out. “I feel me really dumb,” wrote one person who’d found out her ADHD medication wasn’t covered. Another customer said she was reminded of the John Grisham novel The Rainmaker, in which an insurance company has a policy of rejecting every claim. Trudy Slawson, a 65-year-old in Great Falls, Mont., who bought an HIIQ-administered plan in 2016, thought she had comprehensive coverage until getting a surprise bill for $60,000 after her husband’s emergency gallbladder removal. The insurer paid only $100. “I believed what they were telling me,” she says.
"Grifters gonna grift" remains the guiding philosophy of policy coming out of this administration.