Casey: Misleading Junk Plans Don’t Cover Pre-Existing Conditions
Washington, D.C. – As many COVID-19 survivors are struggling with long-term symptoms, U.S. Senators Bob Casey (D-PA), Tammy Baldwin (D-WI) and Debbie Stabenow (D-MI) introduced the Junk Plan Accountability and Disclosure Act (S. 1002) to protect consumers from being misled into enrolling in junk plans that fail to offer comprehensive coverage or basic consumer protections put in place as a result of the Affordable Care Act (ACA). Junk plans, which can include short-term, limited duration health plans, excepted benefit plans and health sharing ministries, are sold outside of the ACA’s critical consumer protections. As a result, they may leave individuals and families susceptible to exorbitant out-of-pocket health care costs.
"Congress must ensure consumers are not being deceived by false advertisements and purchasing junk plans that don't meet their needs," said Senator Casey. "No one should find out that the health insurance they paid their hard-earned money for doesn’t cover them when they need it most."
“The Trump administration expanded junk insurance plans that can deny coverage to people with pre-existing conditions and don’t have to cover essential services like maternity care, prescription drugs, substance use disorders and emergency room care. It’s time to turn the page,” said Senator Baldwin. “With nearly 30 million Americans diagnosed with COVID-19, we should be working during this pandemic, and after, to expand quality, affordable health care that provides all of the essential benefits of the Affordable Care Act. Junk insurance plans don’t provide guaranteed protections and we need to take action to protect consumers so they don’t get stuck paying thousands of dollars out of pocket when they need health care.”
“When someone purchases health insurance coverage, they need to know that their plan will cover them when they need it. Unfortunately, many people have been deceived by online advertising and claims by unscrupulous brokers and agents selling health insurance without the protections of the Affordable Care Act. These ‘junk plans’ are misleading and many times don’t protect people with pre-existing conditions. This bill cracks down on deceptive advertisements and helps ensure American consumers know what type of coverage they are buying,” said Senator Stabenow.
In October 2019, Senator Casey released an investigative report about the consumer experience of shopping online for health insurance. The report found that misleading advertisements found on online search engines were diverting individuals to websites that sell junk plans. A follow up, secret shopper investigation from the Government Accountability Office proved that some brokers and agents are enrolling consumers in junk plans by lying about what those plans cover. During their time in office, the Trump Administration took several steps to drive consumers away from comprehensive coverage on the ACA marketplaces and expand enrollment in junk insurance. For example, they slashed funding for outreach and enrollment efforts for ACA plans, and they allowed extended enrollment in short-term, limited duration plans.
The Junk Plan Accountability and Disclosure Act would take the following steps to protect consumers:
- Clarify and strengthen the Federal Trade Commission’s authority to take enforcement action against misleading online health coverage ads;
- Require junk plans to provide a plain language explanation of benefits before enrollment and a warning to inform consumers that the plan is not comprehensive;
- Require junk plans to issue annual reports detailing their enrollment, the amount of claims that are submitted to them and the amount of claims that they deny; and
- Ensure consistent funding for federal ACA outreach and enrollment efforts and create a separate open enrollment outreach and education grant program for states with state-based marketplaces, like the one in Pennsylvania.
To avoid junk plans and enroll in comprehensive coverage, consumers should take care to enroll in health insurance plans only through an Affordable Care Act marketplace, such as www.pennie.com in Pennsylvania or www.healthcare.gov in states that use the federal website. Recently, President Biden opened a special enrollment period to give consumers extra time to enroll in comprehensive coverage. Pennsylvania has implemented a similar special enrollment period for Pennie, meaning that consumers can enroll in comprehensive coverage until August 15. Recent changes through the American Rescue Plan mean that consumers may receive a larger monthly subsidy for their ACA plan and see lower premiums than in the past.
The Junk Plan Accountability and Disclosure Act has been endorsed by a wide range of health care and patient advocacy groups, including Susan G. Komen, the American Diabetes Association and Families USA.
Read more about the Junk Plan Accountability and Disclosure Act here.