* . *
  • About
  • Advertise
  • Privacy & Policy
  • Contact
Friday, October 3, 2025
Earth-News
  • Home
  • Business
  • Entertainment
    Taylor Swift Releases New Album The Life of a Showgirl : Listen and Read the Full Credits – Yahoo

    Taylor Swift Releases New Album The Life of a Showgirl : Listen and Read the Full Credits – Yahoo

    Toni Braxton Is Turning Her Biggest Hits Into Lifetime Movies – Yahoo

    Toni Braxton Is Turning Her Biggest Hits Into Lifetime Movies – Yahoo

    Major airline to offer new in-flight entertainment options for passengers – PennLive.com

    Major airline to offer new in-flight entertainment options for passengers – PennLive.com

    Penn State-Themed Restaurant and Entertainment Spot Happy Valley Live Set to Open in State College – StateCollege.com

    Penn State-Themed Restaurant and Entertainment Spot Happy Valley Live Set to Open in State College – StateCollege.com

    The Police Made Chart History With This 1979 Hit Nearly 50 Years Ago – Yahoo

    How The Police Changed Music Forever with Their Iconic 1979 Hit Nearly 50 Years Ago

    Good Deed Entertainment Acquires Worldwide Rights To Liza Mandelup’s Documentary ‘Caterpillar’ – Deadline

    Good Deed Entertainment Lands Global Rights to Liza Mandelup’s Captivating Documentary ‘Caterpillar

  • General
  • Health
  • News

    Cracking the Code: Why China’s Economic Challenges Aren’t Shaking Markets, Unlike America’s” – Bloomberg

    Trump’s Narrow Window to Spread the Truth About Harris

    Trump’s Narrow Window to Spread the Truth About Harris

    Israel-Gaza war live updates: Hamas leader Ismail Haniyeh assassinated in Iran, group says

    Israel-Gaza war live updates: Hamas leader Ismail Haniyeh assassinated in Iran, group says

    PAP Boss to Niger Delta Youths, Stay Away from the Protest

    PAP Boss to Niger Delta Youths, Stay Away from the Protest

    Court Restricts Protests In Lagos To Freedom, Peace Park

    Court Restricts Protests In Lagos To Freedom, Peace Park

    Fans React to Jazz Jennings’ Inspiring Weight Loss Journey

    Fans React to Jazz Jennings’ Inspiring Weight Loss Journey

    Trending Tags

    • Trump Inauguration
    • United Stated
    • White House
    • Market Stories
    • Election Results
  • Science
  • Sports
  • Technology
    Technology Is Becoming More Important Than Humans In CX – No Jitter

    Technology Is Becoming More Important Than Humans In CX – No Jitter

    A Tech Expo Shows What China Can Make, but Not Who’ll Buy It All – The New York Times

    Inside China’s Tech Expo: Cutting-Edge Innovations Face Uncertain Demand

    Steampunk Metal Oval Technology Sense Sunglasses Personality Handmade Chain Multicolor Sunglasses UV400 – The San Joaquin Valley Sun

    Steampunk Metal Oval Sunglasses with Handmade Multicolor Chain – Bold UV400 Protection and Unique Style

    STELLA Automotive AI Appoints Fred Seidelman as Chief Technology Officer – Yahoo Finance

    STELLA Automotive AI Appoints Fred Seidelman as New Chief Technology Officer

    Saving Energy and Money with Smart Technology – Terms of Service with Clare Duffy – Podcast on CNN Podcasts – CNN

    Saving Energy and Money with Smart Technology – Terms of Service with Clare Duffy – Podcast on CNN Podcasts – CNN

    Four Strategic Signals Technology Leaders Are Tuning In To – SPONSOR CONTENT FROM ARM – Harvard Business Review

    Four Essential Strategic Signals Every Technology Leader Should Watch

    Trending Tags

    • Nintendo Switch
    • CES 2017
    • Playstation 4 Pro
    • Mark Zuckerberg
No Result
View All Result
  • Home
  • Business
  • Entertainment
    Taylor Swift Releases New Album The Life of a Showgirl : Listen and Read the Full Credits – Yahoo

    Taylor Swift Releases New Album The Life of a Showgirl : Listen and Read the Full Credits – Yahoo

    Toni Braxton Is Turning Her Biggest Hits Into Lifetime Movies – Yahoo

    Toni Braxton Is Turning Her Biggest Hits Into Lifetime Movies – Yahoo

    Major airline to offer new in-flight entertainment options for passengers – PennLive.com

    Major airline to offer new in-flight entertainment options for passengers – PennLive.com

    Penn State-Themed Restaurant and Entertainment Spot Happy Valley Live Set to Open in State College – StateCollege.com

    Penn State-Themed Restaurant and Entertainment Spot Happy Valley Live Set to Open in State College – StateCollege.com

    The Police Made Chart History With This 1979 Hit Nearly 50 Years Ago – Yahoo

    How The Police Changed Music Forever with Their Iconic 1979 Hit Nearly 50 Years Ago

    Good Deed Entertainment Acquires Worldwide Rights To Liza Mandelup’s Documentary ‘Caterpillar’ – Deadline

    Good Deed Entertainment Lands Global Rights to Liza Mandelup’s Captivating Documentary ‘Caterpillar

  • General
  • Health
  • News

    Cracking the Code: Why China’s Economic Challenges Aren’t Shaking Markets, Unlike America’s” – Bloomberg

    Trump’s Narrow Window to Spread the Truth About Harris

    Trump’s Narrow Window to Spread the Truth About Harris

    Israel-Gaza war live updates: Hamas leader Ismail Haniyeh assassinated in Iran, group says

    Israel-Gaza war live updates: Hamas leader Ismail Haniyeh assassinated in Iran, group says

    PAP Boss to Niger Delta Youths, Stay Away from the Protest

    PAP Boss to Niger Delta Youths, Stay Away from the Protest

    Court Restricts Protests In Lagos To Freedom, Peace Park

    Court Restricts Protests In Lagos To Freedom, Peace Park

    Fans React to Jazz Jennings’ Inspiring Weight Loss Journey

    Fans React to Jazz Jennings’ Inspiring Weight Loss Journey

    Trending Tags

    • Trump Inauguration
    • United Stated
    • White House
    • Market Stories
    • Election Results
  • Science
  • Sports
  • Technology
    Technology Is Becoming More Important Than Humans In CX – No Jitter

    Technology Is Becoming More Important Than Humans In CX – No Jitter

    A Tech Expo Shows What China Can Make, but Not Who’ll Buy It All – The New York Times

    Inside China’s Tech Expo: Cutting-Edge Innovations Face Uncertain Demand

    Steampunk Metal Oval Technology Sense Sunglasses Personality Handmade Chain Multicolor Sunglasses UV400 – The San Joaquin Valley Sun

    Steampunk Metal Oval Sunglasses with Handmade Multicolor Chain – Bold UV400 Protection and Unique Style

    STELLA Automotive AI Appoints Fred Seidelman as Chief Technology Officer – Yahoo Finance

    STELLA Automotive AI Appoints Fred Seidelman as New Chief Technology Officer

    Saving Energy and Money with Smart Technology – Terms of Service with Clare Duffy – Podcast on CNN Podcasts – CNN

    Saving Energy and Money with Smart Technology – Terms of Service with Clare Duffy – Podcast on CNN Podcasts – CNN

    Four Strategic Signals Technology Leaders Are Tuning In To – SPONSOR CONTENT FROM ARM – Harvard Business Review

    Four Essential Strategic Signals Every Technology Leader Should Watch

    Trending Tags

    • Nintendo Switch
    • CES 2017
    • Playstation 4 Pro
    • Mark Zuckerberg
No Result
View All Result
Earth-News
No Result
View All Result
Home Health

Reports of Unauthorized Obamacare Plan-Switching and Sign-Ups Trigger Concern

April 15, 2024
in Health
Reports of Unauthorized Obamacare Plan-Switching and Sign-Ups Trigger Concern
Share on FacebookShare on Twitter

Federal and state regulators aren’t doing enough to stop the growing problem of rogue health insurance brokers making unauthorized policy switches for Affordable Care Act (ACA) policyholders, say consumers, agents, nonprofit enrollee assistance groups, and other insurance experts.

“We think it’s urgent and it requires a lot more attention and resources,” said Jennifer Sullivan, director of health coverage access for the Center on Budget and Policy Priorities.

The CMS, which oversees the ACA, “has acknowledged the issue,” said former Oklahoma insurance commissioner John Doak. “But it appears their response is inadequate.”

The reactions follow a KFF Health News article outlining how licensed brokers’ easy access to policyholder information on healthcare.gov has led unscrupulous agents to switch people’s policies without express permission. Those agents can then take the commission that comes with signing a new customer. Dozens of people and insurance brokers responded to the earlier report recounting similar situations.

Some switched policyholders end up in plans that don’t include their doctors or the medications they regularly take, or come with higher deductibles than their original coverage choice. If their income or eligibility for premium tax credits is misrepresented, some people end up owing back taxes.

Agents whose clients have been affected say the switches ramped up last year and are continuing into 2024, although quantifying the problem continues to be difficult. The problem seems concentrated on the federal healthcare.gov website, which is the marketplace where people in 32 states buy ACA plans, also known as Obamacare. CMS declined to provide the number of complaints that have been filed.

Even so, CMS representatives said during a December committee meeting of the National Association of Insurance Commissioners (NAIC) that they were “acutely aware” of the problem and were working on solutions.

A similar NAIC gathering was held in March. During those meetings, state regulators urged CMS officials to look for unauthorized switches, rather than reacting only to filed complaints. State regulators also want the agency to tell them sooner about agents or brokers under investigation, and to be provided with the number of affected consumers in their regions.

In an April 4 written statement to KFF Health News, Jeff Wu, acting director of CMS’ Center for Consumer Information & Insurance Oversight, pointed to the agency’s sharp prohibition on agents enrolling people or changing their plans without getting written or recorded consent, and said his team is “analyzing potential additional system controls to block unauthorized or fraudulent activity.”

It is also working with state regulators and large broker agencies, Wu wrote, to identify “the most effective ways to root out bad actors.” He also said more agents and brokers are being suspended or terminated from healthcare.gov.

Wu did not provide, however, a tally of just how many have been sanctioned.

Low-income consumers are often targeted, possibly because they qualify for zero-premium plans, meaning they might not know they’ve been switched or enrolled because they aren’t paying a monthly bill.

Also, rules took effect in 2022 that allow low-income residents to enroll at any time of the year, not just during the annual open enrollment period. While the change was meant to help people who most need to access coverage, it has had the unintended effect of creating an opportunity for this scheme to ramp up.

“There have been bad apples out there signing people up and capturing the commissions to do so for a while, but it’s exacerbated in the last couple of years, turning it from a few isolated incidents to something more common,” said Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University.

Many victims don’t know they’ve been switched until they try to use their plans — either because agents changed the policy without talking to them or because the consumer unknowingly enrolled by responding to online advertisements promising gift cards, government subsidies, or free health insurance.

The challenge now is how federal regulators and their counterparts in the states can thwart the activity without diminishing enrollment — a top priority for the marketplace. In fact, Obamacare’s record-breaking enrollment figures are being touted prominently in President Joe Biden’s reelection campaign.

Thwarting the switches “really comes down to oversight and enforcement,” Corlette said. “As soon as regulators identify someone who is engaged in unauthorized plan-switching or enrollment, they need to cut them off immediately.”

That isn’t simple.

For starters, consumers or their agents must report suspected problems to state and federal regulators before investigations are launched.

Such investigations can take weeks and states generally don’t have access to complaints until federal investigators finish an inquiry, state regulators complained during the NAIC meetings.

Doak attended the December meeting, where he urged federal regulators to look for patterns that might indicate unauthorized switching — such as policyholders’ coverage being changed multiple times in a short period — and then quickly initiate follow-up with the consumer.

“All regulators have a duty to get on top of this issue and protect the most vulnerable consumers from unknowingly having their policies moved or their information mistreated,” Doak told KFF Health News. He is now executive vice president of government affairs for Insurance Care Direct, a health insurance brokerage.

Being more proactive requires funding.

Wu said the agency’s administrative budget has remained nearly flat for 13 years even as enrollment has grown sharply in the ACA and the other health programs it oversees.

And the complaint process itself can be cumbersome because it can involve different state or federal agencies lacking coordination.

Even after complaints are filed, state or federal officials follow up directly with the consumer, who might have limited English proficiency, lack an email address, or simply not answer their phone — which can stall or stop a resolution, said Katie Roders Turner, MPH, executive director of the Family Healthcare Foundation, a Tampa Bay, Florida, nonprofit that helps people enroll or deal with problems that arise with their plans.

Suggested improvements include creating a central form or portal for complaints and beefing up safeguards on the healthcare.gov site to prevent such unauthorized activity in the first place.

Currently, licensed agents need only a name, date of birth, and state of residence to access policyholder information and make changes. That information is easy to obtain.

States that run their own marketplaces — there are 18 and the District of Columbia — often require more information, such as a one-time passcode sent to the consumer, who then gives it to their chosen agent.

In the meantime, the frustration is increasing.

Lauren Phillips, a sales agent in Georgia, said she reached out to an agent in Florida who was switching one of her clients, asking her to stop. When it happened again to the same client, she reported it to regulators.

“Their solution was for me to just watch the policy and fix it if it happens again, which is not a viable solution, “Phillips said.

Recently, after noticing the client’s policy had been switched again, she reported it and changed it back. When she checked two mornings later, the policy had been terminated.

“Now my client has no insurance at all,” Phillips said. “They say they are working on solutions. But here we are in the fourth month of the year and agents and consumers are still suffering at the hands of these terrible agents.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — an independent source of health policy research, polling, and journalism. Learn more about KFF.

>>> Read full article>>>
Copyright for syndicated content belongs to the linked Source : MedPageToday – https://www.medpagetoday.com/special-reports/features/109632

Tags: healthReportsunauthorized
Previous Post

Congress Can Take Action to Prevent Older Adult Falls and Associated Opioid Use

Next Post

‘A Pain in the Ass’: What We Heard This Week

The current state of shutdown politics – CNN

Inside the High-Stakes Battle Over Government Shutdowns

October 3, 2025
Bhagwat rings ‘warning bell’ on Himalayas, ecology threats – Times of India

Bhagwat rings ‘warning bell’ on Himalayas, ecology threats – Times of India

October 3, 2025
117-Year-Old Woman’s Diet Could Help Us All Live Longer – ScienceAlert

117-Year-Old Woman’s Diet Could Help Us All Live Longer – ScienceAlert

October 3, 2025
The Best Time to Eat Breakfast, Backed by Science—and Why It Matters More Than You Think – Real Simple

The Ideal Time to Eat Breakfast: Surprising Science-Backed Reasons Why It Matters

October 3, 2025
Lifestyle and stress erode heart health advantage in long-term US immigrants – News-Medical

Lifestyle and stress erode heart health advantage in long-term US immigrants – News-Medical

October 3, 2025
Artificial Intelligence Technology Solutions Deploys RIO Security Solutions – TipRanks

Artificial Intelligence Technology Solutions Unveils Game-Changing RIO Security Innovations

October 3, 2025
Top-12 NFL running games: Which teams are helping our RBs score fantasy football points this season? – Yahoo Sports

Top-12 NFL running games: Which teams are helping our RBs score fantasy football points this season? – Yahoo Sports

October 3, 2025
FIRST LOOK: Official match ball of FIFA World Cup ‘26 – Yahoo Sports

Get an Exclusive First Look at the Official Match Ball of FIFA World Cup 2026!

October 3, 2025
Arts economy grows, but funding lags on Long Island – Long Island Business News

Long Island’s Arts Economy Thrives Despite Ongoing Funding Challenges

October 3, 2025
Taylor Swift Releases New Album The Life of a Showgirl : Listen and Read the Full Credits – Yahoo

Taylor Swift Releases New Album The Life of a Showgirl : Listen and Read the Full Credits – Yahoo

October 3, 2025

Categories

Archives

October 2025
M T W T F S S
 12345
6789101112
13141516171819
20212223242526
2728293031  
« Sep    
Earth-News.info

The Earth News is an independent English-language daily published Website from all around the World News

Browse by Category

  • Business (20,132)
  • Ecology (849)
  • Economy (869)
  • Entertainment (21,743)
  • General (17,387)
  • Health (9,912)
  • Lifestyle (882)
  • News (22,149)
  • People (871)
  • Politics (881)
  • Science (16,080)
  • Sports (21,370)
  • Technology (15,852)
  • World (852)

Recent News

The current state of shutdown politics – CNN

Inside the High-Stakes Battle Over Government Shutdowns

October 3, 2025
Bhagwat rings ‘warning bell’ on Himalayas, ecology threats – Times of India

Bhagwat rings ‘warning bell’ on Himalayas, ecology threats – Times of India

October 3, 2025
  • About
  • Advertise
  • Privacy & Policy
  • Contact

© 2023 earth-news.info

No Result
View All Result

© 2023 earth-news.info

No Result
View All Result

© 2023 earth-news.info

Go to mobile version