Congress needs to eliminate harmful billing practices

Insurers are only interested in their bottom line

October 24, 2021 5:00 am

Medication set against $100 bills.

Recent years have been hard for Americans across the country. With a string of tragic weather events like Hurricane Ida and the Colorado bomb cyclone, many Americans will be out of a job and turn to short-term, limited-duration health insurance, or STLDI, plans to have some level of health coverage during their period of unemployment. This is a necessary move for many Americans, particularly those with chronic diseases, because they rely on medicines to manage their conditions. But for many Coloradans, the costs of health care plans as well as lifesaving drugs are rising too rapidly, with over 50% worried about how they will afford them.

This widespread and common panic, combined with health insurance being a basic necessity, results in many Americans opting into harmful plans like STLDIs or plans with accumulator adjustment programs. What they do not know before buying into these plans is that “junk insurance” is exempt from many Affordable Care Act requirements and can exclude coverage for preexisting conditions. They are also not required to cover preventive services and have a host of other substantial risks for consumers.

What’s worse is that accumulator adjustment programs have also become all too common in the insurance industry, just as junk insurance plans have. Accumulator adjustment programs make it possible for insurers to deny the use of cost-saving prescription drug coupons that count towards deductibles. For some patients, that means that their coupons may run out before the end of the year, leaving them unable to pay the high cost of prescription medication that is, for many, lifesaving.

These plans are predatory in nature and the fact of the matter is that Coloradans want these plans eliminated from the marketplace. Recent polling from ALG Research and Keating Research, conducted on behalf of Consumers for Quality Care, showed that 86% of Coloradans want to prohibit insurance companies from selling these barebones plans that drive up the final cost of care. Sadly, over 75% of insurers think that accumulator adjustment programs might become more prevalent. In the next year, as many as 80% of consumers could face the repercussions of the popularity of these accumulator adjustment programs.

Last year, the Centers for Medicare and Medicaid allowed for the expansion of accumulator adjustment programs during the pandemic. This is unacceptable. Access to affordable health care is a human right, but insurers are only interested in their bottom line. Policymakers must stick up for Coloradans, not corporate entities, to ensure broad access to affordable and quality health care, as well as prescription drugs.

Moving forward, policymakers need to work to ensure that plans like STDLIs and plans with accumulator adjustment programs hidden within them are eliminated from the market or at the very least scaled back to only short-term options. This is the only way that we can truly protect our most vulnerable citizens and ensure that insurance companies are not predating on Americans who are simply looking for the health care that they need and deserve.

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Porter Bennett
Porter Bennett

Porter Bennett is a Colorado native who works as a political consultant, campaign manager and community organizer. He has worked in the Colorado political field for the last three years, serving as a campaign manager for city council, school board, state Senate and congressional races. Porter went to University of Colorado Boulder and earned a degree in economics.