It’s time to protect patients from short-term health plans

https://www.lls.org/advocate/protecting-patients-junk-insurance

Leukemia Lymphoma Society (LLS) supports actions that regulate or prohibit “junk insurance” 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

LLS advocate Sam Bloechl thought he was doing everything right. After experiencing back pain that wouldn’t go away, he spoke to an insurance broker about upgrading his insurance plan to better cover any treatment he might need. Sam’s broker insisted she had the perfect plan for him. It wasn’t.

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—a type of “junk insurance.”

Sam isn’t alone. Patients with pre-existing conditions are penalized by low-quality policies, known as “junk insurance” 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—much more than they’d face if they had traditional health insurance, a recent Milliman study funded by LLS reveals. The plans often rely on misleading marketing and are misunderstood by consumers who buy them. And patients have no right to appeal plan decisions.

Moreover, junk plans drive up more than a patient’s out-of-pocket costs—they threaten prices across the health insurance market. As younger and healthier individuals choose these cheaper “junk plans” over comprehensive insurance, premiums for comprehensive insurance are expected to rise.

Solutions

LLS supports actions that regulate or prohibit “junk insurance” 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:

•    Short-term, limited-duration insurance
•    Health care sharing ministries
•    Farm Bureau plans
•    Grandfathered plans
•    Multiple employer welfare arrangements and association health plans
•    Spurious single-employer self-insured group health plans
•    Minimum essential coverage-only plans
•    Excepted benefit plans

report published by 30 patient organizations, including LLS, explains these types of plans in depth—and details how state and federal lawmakers can help protect patients and consumers from these dangerous plans. 

LLS 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.

Price of Addiction: Oregon AG outlines drug-maker’s use of aggressive tactics to win over doctors

http://www.bizjournals.com/portland/blog/health-care-inc/2015/08/price-of-addiction-oregon-ag-outlines-drug-makers.html?ana=e_ptl_hc&u=FAuoHGaGEPdmk4X6khnaiw045b16af&t=1438961271

Oregon entered into a $1.1 million settlement with drugmaker Insys Therapeutics in connection with its marketing of Subsys, an opioid drug.

Behind the $1.1 million settlement between Oregon Attorney General Ellen Rosenblum and a drug manufacturer lies a tale of “unconscionable, false and deceptive sales tactics,” including wining and dining, and even flirting with, Oregon doctors.