Because states are the primary regulators of insurance, tamping down on health care scams can be like playing a game of whack-a-mole — when one state takes action, scammers move to another one to open shop.
It took nearly a year for Kelly Macauley to realize the health plan she bought while shopping for insurance coverage last October was not, in fact, insurance. Sure, red flags popped up along the way, but when she called to complain, she said, she was met with explanations that sounded reasonable enough and kept her paying her $700 monthly premiums.
“That was never, ever mentioned to me,” Macauley said. “I honestly believed I was buying legitimate medical insurance.” Volk identified telltale signs of that wrong path: if the person selling you a plan starts asking about your health history, or if they refuse to send you information about the plan altogether, or they agree to provide that information only after you give them your payment information.
“I don’t want to sound political,” said Navarro, an elected Democrat, “but the previous presidential administration was really pushing the skinny plans and the alternatives to the ACA, and I don’t necessarily think that they understood the fraud that was associated with these plans.” Court filings from October indicate the California attorney general is investigating Jericho Share — the health care sharing ministry that Kelly Macauley said she unwittingly bought a plan from — to see whether it is in compliance with the state’s requirements for health care sharing ministries.
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