Health Insurance That Doesn’t Cover the Bills Has Flooded the Market Under Trump

Greenbeard · Sep 17, 2019

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

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.

Rogue Valley · Sep 17, 2019

Greenbeard said:
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.

Trump said in late June the WH would release its healthcare plan in a few weeks. This is September. Where is it?

Rexedgar · Sep 17, 2019

Rogue Valley said:
Trump said in late June the WH would release its healthcare plan in a few weeks. This is September. Where is it?

....same place as affordable healthcare and infrastructure.

Manc Skipper · Sep 17, 2019

Detractors claim that Obamacare pushed prices up. That was due to junk insurance being forced off the market. What's the point of paying less for insurance that doesn't cover you? Trump thinks you deserve the "option" of paying to not be covered.

Greenbeard · Sep 17, 2019

Rogue Valley said:
Trump said in late June the WH would release its healthcare plan in a few weeks. This is September. Where is it?

Helix · Sep 17, 2019

it's sad how far we are away from a regular first world health care system due to idiots.

Mycroft · Sep 17, 2019

Greenbeard said:
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.

I support laws that require an insurance seller to honestly present all the details of a plan they want to sell. I support the notion of "caveat emptor".

If the details of a plan were honestly presented and the buyer agreed to buy the plan, they have nobody to blame but themselves if they didn't understand what they were buying.

Northern Light · Sep 17, 2019

Helix said:
it's sad how far we are away from a regular first world health care system due to idiots.

It's pretty much too late at this point. It was one thing when we had no system in place and attempts to create one kept getting hijacked; but once a highly incompetent, partisan and ineffectual system got created, it made such a mess that detangling it will be next to impossible. And I think that was by design.

We will be distracted for years by the constant in-fighting caused by the creation of this ineffectual system, so much so that people will be baited and switched away from ever thinking about the genuine article.

Obscurity · Sep 17, 2019

Mycroft said:
I support laws that require an insurance seller to honestly present all the details of a plan they want to sell. I support the notion of "caveat emptor".

If the details of a plan were honestly presented and the buyer agreed to buy the plan, they have nobody to blame but themselves if they didn't understand what they were buying.

Agreed. My uncle had one of these plans. They are not honestly presented. I talked him into cancelling.

Mr Person · Sep 17, 2019

Mycroft said:
I support laws that require an insurance seller to honestly present all the details of a plan they want to sell. I support the notion of "caveat emptor".

If the details of a plan were honestly presented and the buyer agreed to buy the plan, they have nobody to blame but themselves if they didn't understand what they were buying.

Oh, stop lying. You just want to convince the Americans that they shouldn't pay for anyone else's health care.

Mr Person · Sep 17, 2019

Rogue Valley said:
Trump said in late June the WH would release its healthcare plan in a few weeks. This is September. Where is it?

Lodged in his colon

Hatuey · Sep 17, 2019

Mr Person said:
Oh, stop lying. You just want to convince the Americans that they shouldn't pay for anyone else's health care.

You can tell someone's post is full of bull**** when they think of health insurance sales people as 'honest'.

Sent from the Matrioshka in the WH Christmas tree.

Helix · Sep 17, 2019

Northern Light said:
It's pretty much too late at this point. It was one thing when we had no system in place and attempts to create one kept getting hijacked; but once a highly incompetent, partisan and ineffectual system got created, it made such a mess that detangling it will be next to impossible. And I think that was by design.

We will be distracted for years by the constant in-fighting caused by the creation of this ineffectual system, so much so that people will be baited and switched away from ever thinking about the genuine article.

I tend to wonder if systemic collapse will eventually get us there, sort of like how the Great Depression got us social programs. It's a dumb way to do it, but it's a way.

Drawdown · Sep 17, 2019

Helix said:
it's sad how far we are away from a regular first world health care system due to idiots.

Require health insurance to own a car and you will see compliance rates increase significantly

Greenbeard · Sep 17, 2019

Mycroft said:
I support laws that require an insurance seller to honestly present all the details of a plan they want to sell. I support the notion of "caveat emptor".

If the details of a plan were honestly presented and the buyer agreed to buy the plan, they have nobody to blame but themselves if they didn't understand what they were buying.

Hey, fun fact. The ACA required insurers to provide a standardized, simplified, easy-to-understand Summary of Benefits and Coverage to consumers so they can make informed decisions and understand the complex financial products they're purchasing before they buy.

Guess what the Trump administration exempted short-term junk plans from having to provide? That.

CMS-9924-F

Because short-term, limited-duration insurance is not individual health insurance coverage under the PHS Act, it is not subject to the SBC [Summary of Benefits and Coverage] requirements established under section 2715 of the PHS Act.

At least they're acknowledging this garbage doesn't even count as insurance. (Though they explicitly declined to require these sham companies to have to disclose that to consumers.)

The point of the Grifter President's policy is to screw consumers and let snake oil salesman flourish. Mission accomplished.

JasperL · Sep 17, 2019

Northern Light said:
It's pretty much too late at this point. It was one thing when we had no system in place and attempts to create one kept getting hijacked; but once a highly incompetent, partisan and ineffectual system got created, it made such a mess that detangling it will be next to impossible. And I think that was by design.

We will be distracted for years by the constant in-fighting caused by the creation of this ineffectual system, so much so that people will be baited and switched away from ever thinking about the genuine article.

I don't see where the "mess" is that cannot get untangled. The ACA at its core is pretty simple - expand Medicaid, exchanges for private plans with some fairly straightforward minimum coverage requirements, and subsidies that decrease as income increases. What part of that is a mess?

It actually simplified insurance in many ways. The OP is about plans that are absolute garbage, 40% payout rates, don't cover what they promise, etc. There are anecdotal accounts of people getting conned because they didn't understand the limits. That would not happen under ACA pre-Trump, but what people COULD do when buying a private plan on or off the exchange was know that they were NOT buying that kind of BS. Any plan they bought covered hospitalization, cancer, heart disease, no exclusions for pre-existing conditions to that couldn't come back to bite someone, etc. Consumers of insurance could rely on the verbal assurances because the law required the core to be sound.

Further, if the GOP, say, wanted to unwind ACA, why would that be hard? It's being done step by destructive step without legislation, but I don't see the barrier to another plan should by some magic the GOP gets off their lazy asses and does something.

Mycroft · Sep 17, 2019

Greenbeard said:
Hey, fun fact. The ACA required insurers to provide a standard, simplified, easy-to-understand Summary of Benefits and Coverage so they can make informed decisions and understand the complex financial products they're purchasing before they buy.

Guess what the Trump administration exempted short-term junk plans from having to provide? That.

CMS-9924-F

At least they're acknowledging this garbage doesn't even count as insurance.

The point of the Grifter President's policy is to screw consumers and let snake oil salesman flourish. Mission accomplished.

As I said, I support laws that require an insurance seller to honestly present all the details of a plan they want to sell.

What I don't support...and what Obamacare did...is telling insurance sellers what they were allowed and not allowed to put in their plans and telling buyers what they HAD to buy...or else.

Let the buyer choose and let the buyer live with what they choose...good or bad.

Northern Light · Sep 17, 2019

JasperL said:
I don't see where the "mess" is that cannot get untangled. The ACA at its core is pretty simple - expand Medicaid, exchanges for private plans with some fairly straightforward minimum coverage requirements, and subsidies that decrease as income increases. What part of that is a mess?

It actually simplified insurance in many ways. The OP is about plans that are absolute garbage, 40% payout rates, don't cover what they promise, etc. There are anecdotal accounts of people getting conned because they didn't understand the limits. That would not happen under ACA pre-Trump, but what people COULD do when buying a private plan on or off the exchange was know that they were NOT buying that kind of BS. Any plan they bought covered hospitalization, cancer, heart disease, no exclusions for pre-existing conditions to that couldn't come back to bite someone, etc. Consumers of insurance could rely on the verbal assurances because the law required the core to be sound.

Further, if the GOP, say, wanted to unwind ACA, why would that be hard? It's being done step by destructive step without legislation, but I don't see the barrier to another plan should by some magic the GOP gets off their lazy asses and does something.

I understand where you're coming from, I really do, but our government has ceased to really function for the people. The partisan grandstanding and blocking of any real reforms is digging our country an early grave. We are not going to see a good health care system in our lifetimes so long as special interests continue to control decisions that affect hundreds of millions of people.

Not to mention, all signs point to our credit rating eventually being downgraded once our GDP can't even pay our debt interest.

Helix said:
I tend to wonder if systemic collapse will eventually get us there, sort of like how the Great Depression got us social programs. It's a dumb way to do it, but it's a way.

Honestly, I think it may be the only way to get a lot of things done right now. We need a do over, badly. I just don't want to see millions of people suffer in turmoil in the mean time, like in the 1930's. The great tragedy here is that this could all be avoided if the egos in congress could say no to lobbying and try to work together.

Anyway, it's too late IMO.

Greenbeard · Sep 17, 2019

Mycroft said:
As I said, I support laws that require an insurance seller to honestly present all the details of a plan they want to sell.

Laws like the ACA?

What I don't support...and what Obamacare did...is telling insurance sellers what they were allowed and not allowed to put in their plans and telling buyers what they HAD to buy...or else.

Let the buyer choose and let the buyer live with what they choose...good or bad.

Well, gee whiz, most people support requiring insurers to cover pre-existing conditions. Even Trump lies about supporting that. The GOP spent much of 2018 trying in vain to pretend they support such protections for the people.

Mr Person · Sep 17, 2019

Greenbeard said:
Laws like the ACA?

Who would ever have guessed that an ardent Trump supporter would not actually have a clue about what was in legislation they claim a principled stand against.

Mycroft · Sep 17, 2019

Greenbeard said:
Laws like the ACA?

No. We don't need 2000+ pages of legislation to tell sellers to be honest.

Well, gee whiz, most people support requiring insurers to cover pre-existing conditions. Even Trump lies about supporting that. The GOP spent much of 2018 trying in vain to pretend they support such protections for the people.

shrug...

Why should I care about what "most people" support? I don't support the government telling insurers they have to cover pre-existing conditions. I think that should be left between the seller and the buyer.

JasperL · Sep 17, 2019

Greenbeard said:
Hey, fun fact. The ACA required insurers to provide a standardized, simplified, easy-to-understand Summary of Benefits and Coverage to consumers so they can make informed decisions and understand the complex financial products they're purchasing before they buy.

Guess what the Trump administration exempted short-term junk plans from having to provide? That.

CMS-9924-F

At least they're acknowledging this garbage doesn't even count as insurance.

The point of the Grifter President's policy is to screw consumers and let snake oil salesman flourish. Mission accomplished.

Wow, it's almost like screwing customers is a feature, not a bug, and the Trump team are accomplices. What's almost worse than anything is that the document carefully considers comments that suggested various ways to warn consumers about the limited benefits, including plain language summaries, and said, essentially, "nah, this boilerplate saying nothing at all really, and jammed into a long document is fine."

The Departments believe that the requirements relating to both the content and delivery
of the notice as set forth in this final rule strike the appropriate balance to help each consumer
make an informed choice about the type of coverage that is most appropriate for him or her,
while not being overly burdensome to issuers of short-term, limited-duration insurance or
inappropriately biasing the reader against short-term, limited-duration insurance.

Yeah, goodness knows we can't "bias" readers with plain language summaries that tell them what they're about to buy is a piece of crap plan....

Greenbeard · Sep 17, 2019

Mycroft said:
No. We don't need 2000+ pages of legislation to tell sellers to be honest.

I'm not talking about your made-up page total. I'm talking about a specific piece of the law, not the parts that reform Medicare, build up the heath care workforce, boost the nation's public health infrastructure, improve care quality, revamp provider business models to get costs under control, build insurance markets, not even the parts that insure tens of millions of people.

I'm just talking about the disclosure requirements the Trump administration is flouting. The ones that ensure consumers are informed about what they're buying. Do you support those? Do you think they should be enforced?

Why should I care about what "most people" support? I don't support the government telling insurers they have to cover pre-existing conditions. I think that should be left between the seller and the buyer.

Because favoring insurers over consumers, allowing discrimination based on pre-existing conditions, ignoring the clear will of the voters on a top-2 salience issue is potentially an extinction-level policy position for a modern political party. Even doing an about face and lying about supporting this position led to an unprecedented 9-point loss for the anti-consumer GOP last year in an ostensibly strong economy. Keep it up!

Greenbeard · Sep 17, 2019

JasperL said:
Yeah, goodness knows we can't "bias" readers with plain language summaries that tell them what they're about to buy is a piece of crap plan....

Funny that the anti-disclosure rationale is that this stuff isn't actually real insurance so it's not subject to the law, but there's no need to warn or make consumers aware of that determination, right? Might bias consumers against junk policies if they're aware HHS views them as garbage not worthy of its attention.

3leftsdoo · Sep 17, 2019

Greenbeard said:
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.

Blaming this on Trump is ludicrous.

The ACA is a criminal joke which has left tens of millions uninsured or grossly underinsured with often massive premiums and equally massive, bankrupting deductibles.

But I understand that Obama cannot be blamed for delivering us to the devil, but Trump must be.

Liberals gotta liberal...

Health Insurance That Doesn’t Cover the Bills Has Flooded the Market Under Trump

Greenbeard

Rogue Valley

Lead or get out of the way

Rexedgar

Yo-Semite!

Manc Skipper

Wrinkly member

Greenbeard

Helix

Mycroft

Genius is where you find it.

Northern Light

The Light of Truth

Obscurity

Mr Person

A Little Bitter

Mr Person

A Little Bitter

Hatuey

Rule of Two

Helix

Drawdown

Greenbeard

JasperL

Mycroft

Genius is where you find it.

Northern Light

The Light of Truth

Greenbeard

Mr Person

A Little Bitter

Mycroft

Genius is where you find it.

JasperL

Greenbeard

Greenbeard

3leftsdoo