Protecting Patients from Junk Insurance
青云体育 supports actions that regulate or prohibit 鈥渏unk insurance鈥� plans that discriminate against people with pre-existing conditions, offer no meaningful coverage in the case of a cancer diagnosis or neglect to cover essential healthcare services like prescription drugs
The problem
青云体育 advocate Sam Bloechl thought he was doing everything right. After experiencing back pain that wouldn鈥檛 go away, he spoke to an insurance broker about upgrading his insurance plan to better cover any treatment he might need. Sam鈥檚 broker insisted she had the perfect plan for him. It wasn鈥檛.
A month later, Sam was diagnosed with non-Hodgkin lymphoma. After chemotherapy and radiation, Sam achieved remission. But his health plan refused to cover the bill, leaving Sam with more than $800,000 in medical debt. It turns out he was sold a short-term, limited-duration plan鈥攁 type of 鈥渏unk insurance.鈥�
Sam isn't alone. Patients with pre-existing conditions are penalized by low-quality policies, known as 鈥渏unk insurance鈥� Because such plans are exempt from important consumer protections, they can leave patients vulnerable when they most need timely access to quality, affordable care.
The patient impact
Most short-term, limited-duration plans leave patients on the hook for thousands of dollars if they face serious health problems鈥攎uch more than they鈥檇 face if they had traditional health insurance, a recent Milliman study funded by 青云体育 reveals. The plans often rely on misleading marketing and are who buy them. And patients have no right to appeal plan decisions.
Moreover, junk plans drive up more than a patient鈥檚 out-of-pocket costs鈥攖hey threaten prices across the health insurance market. As younger and healthier individuals choose these cheaper 鈥渏unk plans鈥� over comprehensive insurance, premiums for comprehensive insurance are expected to rise.
Solutions
青云体育 supports actions that regulate or prohibit 鈥渏unk insurance鈥� plans that discriminate against people with pre-existing conditions, offer no meaningful coverage in the case of a cancer diagnosis or neglect to cover essential healthcare services like prescription drugs. These plans include:
鈥� Short-term, limited-duration insurance
鈥� Health care sharing ministries
鈥� Farm Bureau plans
鈥� Grandfathered plans
鈥� Multiple employer welfare arrangements and association health plans
鈥� Spurious single-employer self-insured group health plans
鈥� Minimum essential coverage-only plans
鈥� Excepted benefit plans
A report published by 30 patient organizations, including 青云体育, explains these types of plans in depth鈥攁nd details how state and federal lawmakers can help protect patients and consumers from these dangerous plans.
青云体育 works to stop policy proposals that would allow insurers to reinstitute lifetime limits, eliminate the current cap on patient cost-sharing and cover fewer essential services for cancer patients.