As skimpy health plans with limited coverage become more available, people shopping for insurance are at risk of buying a plan that doesn’t meet their needs — because it can be hard to tell the difference.
That’s what happened to Stephanie Sena, an adjunct Villanova University professor whose story was published in The Inquirer on Monday. She isn’t eligible for coverage through the university because her position is part-time, so she turned to the internet for health insurance. She found out the plan she bought wasn’t real insurance when she was hospitalized with sepsis and needed an amputation — and the plan refused to pay a dime.
Some readers were quick to criticize the 39-year-old Philadelphia resident, saying she should have read the plan more closely, done her research, and understood what she was buying before signing up. But a small survey by consumer advocates for the National Association of Insurance Commissioners suggests that Sena’s experience is not unusual.
Interviewers spent an hour going over a short-term health-plan pamphlet with nine individuals of varying income, education, and insurance levels. They found that people often had difficulty identifying how the short-term plan was different from an Affordable Care Act-compliant plan, which is required to cover preexisting conditions, pregnancy, preventive care, and other basics. Participants also had difficulty identifying how the short-term plan would pay for services and whether it would meet their health needs.
“These are people who spent an entire hour with the marketing brochure, with someone helping them, and they still didn’t get it. … This is almost a best-case scenario, and they still didn’t understand,” said Katie Keith, a part-time researcher at Georgetown University’s Center on Health Insurance Reforms, who is part of the group of consumer advocates appointed by the National Association of Insurance Commissioners.
The group commissioned Kleimann Communication Group to conduct the survey in St. Louis, with funding from the Robert Wood Johnson Foundation.
Though small, the survey points to a troubling lack of understanding about health insurance, Keith said, as Republicans loosen ACA restrictions to make plans with varying levels of coverage more accessible.
Here’s what the survey found:
Based on the survey’s findings, the group concluded that regulators need to do more to distinguish ACA plans from those that do not meet the law’s coverage requirements, such as more meaningful disclosures that are harder for consumers to overlook.