GAO study examines marketing practices of ACA-exempt health plans

Government Accountability Office agents made 31 covert phone calls to selected sales representatives in five states between November 2019 and January 2020, posing as individuals needing to purchase health insurance to cover pre-existing conditions to see whether the representatives engaged in deceptive practices.

In eight cases, which GAO has referred to the Federal Trade Commission, the sales representatives engaged in potentially deceptive practices such as claiming a pre-existing condition was covered when plan documents said otherwise, the agency said in a report released yesterday.

In two other cases, the sales representatives were unclear or inconsistent, GAO said. GAO conducted the study in response to a request by Sens. Bob Casey, D-Pa., ranking member of the Special Committee on Aging, and Debbie Stabenow, D-Mich., to examine insurance sales practices for ACA-exempt health plans.

Certain health coverage arrangements sold directly to consumers do not need to comply with all Affordable Care Act requirements, including short-term, limited-duration insurance; limited-benefit plans; health care sharing ministries; and association health plans. AHA has urged policymakers to work with stakeholders on other ways to increase access to health coverage that ensure adequate consumer protections.