Open enrollment, a window when people can pick new health care plans through the Affordable Care Act’s online marketplaces, continues through Dec. 15.
But some consumers might be tempted by ads on social media or in emails that dangle an alternative: “Trumpcare,” which is portrayed as more affordable. .
But there’s a problem: “There is no such thing as Trumpcare,” says Sabrina Corlette, co-director of Georgetown University’s Center on Health Insurance Reforms.
“This is a marketing tactic. It’s impossible to say with any degree of certainty what precisely is the product that is being marketed.”
Because so-called Trumpcare doesn’t refer to any specific plan, consumers need to do extensive research if they’re pursuing one of these offers, which can refer to anything from short-term insurance coverage to cost-sharing plans offered by churches, health care experts note. President Donald Trump had promised to replace the Affordable Care Act with what he said would be “so many different options,” yet his proposal to replace the decade-old ACA has yet to materialize.
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At the same time, health care costs continue to rise, while millions of Americans have lost health care coverage – as well as jobs and income – during the coronavirus pandemic. And that’s adding to the financial pressure they feel as they hunt for new insurance.
Because the products sold through these “Trumpcare” ads may have lower premiums than traditional insurance, that may heighten the risk that a consumer could make a purchase they later regret, since the plans typically lack the same coverage as the comprehensive plans sold through the ACA.
“Especially during the pandemic, with people losing employer-based coverage and severe household financial stress, it’s not surprising people are looking for low-cost solutions,” says Philip Moeller, the author of the guide “Get What’s Yours for Medicare” and whose book “Get What’s Yours in Health Care” will be published in January.
“My advice,” he adds, “is that people really do their homework and exercise vigilance.”
Ads for these products were aggressively marketed this fall on Google and Facebook, and they appeared more frequently in battleground states such as Texas and Florida, according to an October report from ProPublica.
Short-term plans, long-term danger?
Often, the sales pitches for “Trumpcare” refer to short-term insurance plans, which offer limited benefits and often cost less than ACA plans, which by law must provide comprehensive insurance coverage. In 2018, the Trump administration relaxed the rules for short-term plans, allowing them to be sold for durations of 364 days (one day short of a year), rather than the prior limit of three months.
Short-term insurance plans have been growing in popularity. Three million consumers enrolled in them in 2019 through the top nine companies that sell these plans, an increase of 25% from a year earlier, although the total number of U.S. consumers with these plans could be larger, according to a June report from the House Subcommittee on Oversight and Investigations.
But these plans – often used as a stop-gap for people between jobs –have a number of pitfalls, the House report found.
For one, they often exclude coverage for pre-existing conditions. They also offer what the report calls “bare bones” coverage, which may not always be clear to consumers.
Some short-term plans have limitations on coverage for services like hospitalization and prescription drugs, for example. The report found cases where consumers were denied coverage for cancer treatment or heart surgery, leaving them on the hook for hundreds of thousands in out-of-pocket costs.
“It can be really difficult for a consumer to look at these marketing materials and figure out, ‘Does this provide the level of financial protection and access to care that I need if I get sick?’,” says Georgetown’s Corlette. “I don’t want to say all these products are bad – some of them might be perfectly adequate – but there is no standardization in how they are described.”
In other words, buyer beware.
How to shop for insurance
If you are shopping for insurance during open enrollment, start with the ACA marketplaces, Corlette advises.
“A lot of people don’t think they’d qualify for subsidies, but over 80% do qualify,” she notes.
If none of the plans is affordable, Corlette recommends talking with an insurance broker in your community.
“Talk with someone who will have to look you in the eye when you bump into them at the grocery store,” she notes. “Not an anonymous person on a website who only has an interest in making a sale.”
Lastly, work through a checklist when investigating a plan, Moeller recommends. He says your priorities should include:
• Determining the plan’s annual deductible
• Its copays and co-insurance rules
• Whether it has an annual out-of-pocket maximum, and, if so, what that limit is
• Whether pre-existing conditions are covered, and if you could incur higher costs because of that
• If the plan has coverage limits on the services it does cover
• Whether it covers prescription drugs, and its coverage terms for pharmaceuticals
These questions may seem “routine,” Moeller adds, “but based on my experience, consumers don’t think about these questions at all –and people are very trusting.”
This article originally appeared on USA TODAY: Health insurance: Open enrollment is now but should you get Trumpcare?