Billions in Profits, Millions in CEO Salary, and Less and Less Coverage for Everyone Else
Last week, the Trump Administration announced the expansion of junk plans that eliminate key protections under the Affordable Care Act (ACA). These plans can deny coverage for people with pre-existing conditions, impose annual or lifetime limits on care, charge women more, and do not have to cover prescription drug coverage, maternity care, or hospitalization. If you have a pre existing condition including everything from cancer to high blood pressure they can deny you coverage or charge you what they want; and when you get sick they can refuse to cover you if they find you had been sick before.
Here is the story of the largest junk plan provider, UnitedHealth: more for them, less for everyone else.
Of every dollar a customer paid UnitedHealth in premiums, only 44 cents went to medical care. The rest went to things like broker commissions, salaries and profits. UnitedHealth, spent only 43.7 percent of premium dollars from junk plans on medical care, almost half of what they must under ACA-compliant plans. The ACA requires insurance companies spend at least 80 cents of every dollar they take in from premiums on medical costs, meaning that only 20 cents can go toward profits and CEO salaries and other administrative costs. Junk plans, on the other hand, are exempt from this requirement, and so they typically spend dramatically less on care.
- Recent research from the National Association of Insurance Commissioners finds that the average short-term plan in 2017 spent less than 65 percent of premium dollars on medical care.
- Brokers also make higher commission on junk plans; they earn 5 percent commission on ACA-compliant plans, while they make 20 percent commission on junk plans.
People who had a UnitedHealth junk plan warn they don’t deliver quality care. UnitedHealth’s subsidiary that sells junk plans — Golden Rule — didn’t deliver on their promises to customers and got an average review of one out of five stars on Consumer Affairs. The reviews help show just how bad the plans are:
- S. James of Palm Bay, FL: “As you may have read from all the other reviews regarding Golden Rule, they do not pay any of their claims citing ‘pre-existing conditions’ as the reason for their denial. I submitted a claim after a hospitalization and after more than 6 months of reviewing my past medical records, they have denied my claim as a pre-existing condition.“
- Mike of Perkasie, PA: “Horrible insurance. You have to pay out of pocket for any doctors visits, your deductible is 5000 which is ridiculous and the prescription rx prices are horrible. It’s also not part of the Affordable Care Act and cannot be deducted on your write offs. If you decide to get this lousy insurance, make sure you DO NOT get short term, get long term. Why? Because if your blood sugar comes up a little high ONE TIME, which happens to a lot of people every blue moon, they will drop you for a pre-diabetes diagnosis which we all know pre-diabetes is a joke. The blood test after my slightly high sugar blood test results came back PERFECT and that doesn’t matter to them. You cannot appeal. Well, I did but it was a waste of time for me and my doctors office.”
- Karis of Wylie, TX: “I enrolled in gap benefits for three months, and was only supposed to be charged three times. I was charged twice in one month, again the next month, and again, a month after my benefits had ended. I will be calling until that money is back in my account, and never again will I make the mistake of enrolling in insurance with this Ponzi Scheme.”
UnitedHealth made $2.8 billion in profits in Q1 and paid its CEO $83.2 million last year. It is not alone — insurance companies made millions in Q1 of 2018: Aetna made more than $1.2 billion and Anthem raked in over $1.3 billion, all while CEOs are paid millions. Last year, health CEOs made $1.7 billion. Aetna’s CEO made $58.7 million and Centene’s CEO made $24.9 million.