GAO report finds brokers offered false info on coverage for pre-existing conditions

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      GAO report (29 pages):

      For example, the report states, one sales representative told a GAO employee they were purchasing a comprehensive health in plan, but instead sold them two limited benefit insurance plans that don’t cover preexisting conditions.

      “During the call, we repeatedly informed the sales representative that we had diabetes and had recently been seeking treatment for the condition. However, the application filled out by the sales representative on our behalf, which we later obtained, stated that we had not been treated for or diagnosed with diabetes for the past five years,” the report states.

      This indicates that the broker may have intentionally falsified information on the application, which allowed the application to be submitted and the insurance policy to be purchased, but would not allow health care services related to our pre-existing condition to actually be covered under the terms of the policy.”

      Some of the sales representatives refused to let GAO employees see the policy documents before they agreed to buy it.

      Comment by Don McCanne of PNHP: Supposedly the Affordable Care Act requires all insurance plans to cover preexisting conditions, but that is not quite true. Plans that may be exempted from covering preexisting conditions include certain grandfathered plans, short-term limited duration plans, limited benefit plans, health care sharing ministries, and association health plans. Even Medigap plans can be denied to individuals who failed to enroll when they first became eligible. Also at risk is the preexisting coverage mandated by the Affordable Care Act that will be subject to a Supreme Court hearing shortly after the November election.

      The GAO report confirms that the confusion created in the insurance marketplace exposes would be buyers to unscrupulous practices that may leave them without the coverage they thought they were purchasing, or they may be left unprotected merely because of the complexity in the fragmented insurance market that creates confusion as to just what the plans do cover.

      In the midterm election, the Republicans campaigned on promising to cover preexisting conditions at the same time that they supported the repeal of the Affordable Care Act which would have removed such protections from the insurance marketplace. Since they have not offered an ACA replacement plan, their support for covering preexisting conditions was a hollow promise. Although some of the Republicans still contend that preexisting conditions should be covered, they have not made it a major issue in this election since they still have no replacement plan, and they don’t want to be caught with their plans down again.

      Under a single payer Medicare for All plan, this issue goes away. Everyone is completely covered forever. It is astonishing that so many Americans reject Medicare for All while accepting Trump’s support of short-term junk insurance that leaves patients vulnerable to massive medical debt. There must be some loose screws around. We’d better tighten them up.

      Jesus: Hey, Dad? God: Yes, Son? Jesus: Western civilization followed me home. Can I keep it? God: Certainly not! And put it down this minute--you don't know where it's been! Tom Robbins in Another Roadside Attraction

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