Bill Overview
Title: Protecting Patients from Deceptive Health Plans Act
Description: This bill prohibits the sale of health insurance coverage arrangements that are exempt from the federal health insurance requirements unless the individual purchasing the arrangement is enrolled in a plan that provides minimum essential coverage. Further, excepted benefits must be paid without regard to the severity of the illness, injury, diagnosis, or other characteristics related to treatment.
Sponsors: Rep. Hayes, Jahana [D-CT-5]
Target Audience
Population: People purchasing or covered by exempt health insurance plans
Estimated Size: 15000000
- The bill is focused on health insurance coverage arrangements, specifically those that are exempt from federal requirements.
- Individuals who purchase health insurance plans that are currently exempt from providing minimum essential coverage will be directly impacted.
- People who might be deceived by health plans that do not meet essential coverage standards will benefit from this protection.
- The bill affects both sellers and buyers of these excepted insurance plans.
- It aims to ensure more comprehensive coverage for individuals who currently may be underinsured due to gaps in coverage.
Reasoning
- The population impacted by this policy could range widely in terms of demographics, as many individuals unaware of minimum coverage might be spread throughout the U.S.
- Given the focus on plans that circumvent ACA standards, this could affect low-income individuals, freelancers, and people purchasing insurance from non-traditional sources.
- The policy provides protection but might not reach everyone immediately due to logistical constraints and awareness issues.
- Sub-populations in urban areas might be more affected due to a higher availability of insurance options including the deceptive ones targeted by the policy.
- Some might not feel the policy's effects until they experience a health crisis that reveals previous coverage gaps.
- The policy's budget considers both immediate implementation and long-term expansion, with a substantial increase in budget over 10 years.
Simulated Interviews
Graphic Designer (New York, NY)
Age: 34 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 12/20
Statement of Opinion:
- I'm always worried that I'm not covered when something major happens.
- I think this bill sounds like a good safety net.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 5 |
Small Business Owner (Dallas, TX)
Age: 45 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 8/20
Statement of Opinion:
- Insurance is already too expensive, and policies keep changing.
- I hope it doesn’t mean more costs for small business owners like me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 6 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 4 | 4 |
Software Developer (San Francisco, CA)
Age: 29 | Gender: other
Wellbeing Before Policy: 9
Duration of Impact: 0.0 years
Commonness: 15/20
Statement of Opinion:
- I already have pretty solid coverage through my employer.
- This looks like it would be irrelevant to me, thankfully.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 9 | 9 |
| Year 2 | 9 | 9 |
| Year 3 | 9 | 9 |
| Year 5 | 9 | 9 |
| Year 10 | 9 | 9 |
| Year 20 | 9 | 9 |
Retired (Cleveland, OH)
Age: 62 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 5.0 years
Commonness: 12/20
Statement of Opinion:
- I have Medicare, but my daughter buys her own insurance, and I worry about her.
- This might give her a bit more peace of mind.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 9 | 8 |
| Year 10 | 9 | 8 |
| Year 20 | 8 | 8 |
Self-employed Consultant (Phoenix, AZ)
Age: 53 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 10/20
Statement of Opinion:
- I need access to coverage that won’t abandon me if I get sick.
- This bill seems like it ensures protections against those cheap plans.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 9 | 5 |
| Year 10 | 9 | 4 |
| Year 20 | 9 | 3 |
Bartender (Miami, FL)
Age: 39 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- These temporary plans don’t cover enough, and I’d like to worry less when things happen.
- Getting something more reliable sounds reassuring.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 8 | 5 |
| Year 3 | 8 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 3 |
| Year 20 | 6 | 2 |
Barista (Seattle, WA)
Age: 27 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 11/20
Statement of Opinion:
- I’m on the edge about what this means for my family coverage.
- It’s good to see there’s more oversight on those loophole plans.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 4 |
| Year 20 | 7 | 3 |
Retired (Portland, OR)
Age: 65 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 5.0 years
Commonness: 11/20
Statement of Opinion:
- I am mostly worried about my grandkids if their plans didn’t truly cover them.
- Hopefully, it pushes some of these misleading plans out of the market.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 7 | 7 |
Construction Worker (Atlanta, GA)
Age: 58 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 9/20
Statement of Opinion:
- There are gaps in my current insurance that worry me if I ever get seriously ill.
- Glad to see something might fill those gaps.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 3 |
Graduate Student (Chicago, IL)
Age: 23 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 13/20
Statement of Opinion:
- Insurance is confusing, and I’m wary of suddenly losing coverage options after school.
- This policy seems crucial for peace of mind, avoiding deceptive plans.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 7 | 6 |
Cost Estimates
Year 1: $100000000 (Low: $80000000, High: $150000000)
Year 2: $120000000 (Low: $100000000, High: $160000000)
Year 3: $130000000 (Low: $110000000, High: $170000000)
Year 5: $140000000 (Low: $120000000, High: $180000000)
Year 10: $150000000 (Low: $130000000, High: $200000000)
Year 100: $200000000 (Low: $180000000, High: $250000000)
Key Considerations
- The bill could initially raise costs for insurers required to modify existing plans to meet regulatory standards.
- Consumer health outcomes are likely to improve, which can lower future aggregate health costs and public health expenses.
- Enforcing compliance could challenge certain sectors that provide lower-cost insurance options with limited coverage.