![]() McManus strongly disputes that version.“That’s not true. Williams said he put McManus off by saying he did not have the money in his account. Williams said the agent, Michael McManus, asked for an over-the-phone deposit of $449 - one month’s premium payment plus a $100 registration fee - before outlining plan specifics. “There has been a shift in what companies feel they can do.” “There’s definitely a business strategy,” Altman said. ![]() As a result, Pennsylvania Insurance Commissioner Jessica Altman told Congress earlier this year, many consumers are getting misled. ACA-compliant plans require insurers spend about 80 percent of premiums for policy holders’ care.Ĭompanies selling non-compliant plans, meanwhile, have ramped up telemarketing operations and offered hefty commissions as incentives to enroll as many customers as possible. On : Buyer beware: When religion, politics, health care and money collideĪn analysis of recent financial filings by the Houston Chronicle found insurance companies selling plans that don’t comply with ACA rules are spending only about 40 cents of every dollar collected in premiums on customer’s medical claims. It’s just not true anymore.”įurther, because these plans operate outside the rules of the Affordable Care Act, insurance companies backing them can spend less on customer medical claims and pocket a bigger share of premiums for overhead and profit. “We have been telling people for years they didn’t have to worry anymore, that there are no loopholes, no fine print. “We shouldn’t have an insurance market where consumers can accidentally go bankrupt,” said Stacey Pogue, a health policy analyst for the Center for Public Policy Priorities. Regulators and consumer advocates worry that buyers could be vulnerable to staggering medical bills because the coverage they were sold is insufficient. While the full impact of dismantling prior rules is unknown, the Centers for Medicare and Medicaid predicted the number of people buying just one type of newly deregulated plans will rise from 86,000 last year to 1.6 million by 2022. The trade-off, though, is a return to a past when policies came with restrictions and exemptions tucked inside, limiting coverage for pre-existing conditions, prescription drugs, hospitalization and preventative care. The goal is to deliver on an administration promise of lower premiums and greater choice. Under the Trump administration, significant portions of the individual insurance market have been deregulated and rules governing the federal health care law known as Obamacare rolled back. Those kinds of sales calls are only expected to increase, health policy experts warn, now that the guardrails designed to protect unsuspecting consumers from limited health plans and the insurers and agents who push them have come down. “Let’s do it right now,” Williams said he was told. But he omitted that the coverage could be spotty, Williams said, adding that the agent seemed to just want to close the deal. The agent, contracted by a subsidiary of Texas-based US Health Group, promised a plan cheaper and better than those offered through the Affordable Care Act. “Well, yes, I do,” a startled Williams, 63, replied. “I hear you need health insurance,” the agent began. Within moments, Williams’ cellphone rang, before he even left the shop. As it happened, the barber had just bought a new, low-cost plan and promised to have his agent call. ![]() Robert Williams was getting a haircut and mentioned to his barber he would soon need to buy health insurance. Melissa Phillip, Houston Chronicle / Staff photographer Show More Show Less 18, 2019, in Spring.Under the Trump administration, significant portions of the individual insurance market have been deregulated and he was pitched a health plan with spotty coverage. Robert Williams is shown at his home Friday, Oct. Melissa Phillip, Houston Chronicle / Staff photographer Show More Show Less 4 of4 Under the Trump administration, significant portions of the individual insurance market have been deregulated and he was pitched a health plan with spotty coverage. Melissa Phillip, Houston Chronicle / Staff photographer Show More Show Less 3 of4 Melissa Phillip, Houston Chronicle / Staff photographer Show More Show Less 2 of4
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