Transcript for the Piece Audio version of Insurance Scams in Massachusetts

Intro:
WHEN MASSACHUSETTS MANDATED IN 2006 THAT EVERY RESIDENT IN THE STATE HAD TO HAVE HEALTH INSURANCE, THE MARKET BLEW WIDE OPEN FOR INSURANCE COMPANIES. AND WHILE MOST OF THEM HAVE LEGITIMATE PRODUCTS, SOME HAVE TAKEN ADVANTAGE OF A NEW CONSUMER BASE THAT MAY NOT KNOW WHAT IT NEEDS, OR WHAT IT’S GETTING. KAREN BROWN – A KAISER FOUNDATION FELLOW – REPORTS.

[ amb -- auto repair shop ambience, if/as needed]
GARY CLOUTIER HASN’T HAD HEALTH INSURANCE SINCE THE 1980S. HE OWNS AN AUTO-BODY REPAIR SHOP IN WESTFIELD, MASSACHUSETTS, AND TAKES HOME ABOUT 40,000 DOLLARS A YEAR, BUT BUSINESS IS WAY DOWN. HE KNOWS HE'S SUPPOSED TO BUY HEALTH COVERAGE TO COMPLY WITH STATE LAW, BUT HE DOESN'T KNOW WHERE HE'LL FIND THE MONEY.
GC: what else can i cut? i mean i have a truck that's a 99, going on ten years old, 160 something thousand miles on it. i can't afford another truck... last week my phone got turned off. 0:35:11.8 ... i haven't paid myself in a month & a half.
AS LONG AS HE GOES WITHOUT INSURANCE, THE STATE COULD PENALIZE HIM -- AT TAX TIME, HE'LL GET A $900 DOLLAR FINE -- ALTHOUGH HE COULD APPLY FOR A WAIVER. AND FRANKLY, HE WISHES HE DID HAVE HEALTH COVERAGE -- AFTER ALL, HE WORKS AROUND TOXIC CHEMICALS AND HEAVY EQUIPMENT. SO HE STARTED TO SEARCH ON THE INTERNET FOR CHEAP DEALS -- AND THAT LED TO A BARRAGE OF ENTICING OFFERS BY EMAIL AND FAX FROM ANONYMOUS BROKERS.
GC: you know, i come in the morning, and you know, "affordable health insurance." (sounds of rustling through papers.) here the two of the things, they come daily....
WHILE I WAS IN CLOUTIER'S OFFICE, [insert AMB of phone ringing under TRAX], HE GOT A CALL FROM ONE OF THE BROKERS TRYING TO SELL HIM A POLICY.
GC well, not to interrupt you, but i'll give you my situation. ... i'm a small business owner, i'm 47 years old & what would be the bottom line that it would cost me per month to get health insurance, so that i can qualify under MA new laws? $166 & 3 what? ... (FADE UNDER THE REST)
IT SOUNDED LIKE A DEAL COMPARED TO THE $400 DOLLAR PREMIUM HE'D SEEN ON THE STATE'S WEBSITE..... BUT THAT'S BECAUSE THE "AFFORDABLE" PLAN HAS A 10,000 DOLLAR HOSPITAL DEDUCTIBLE, NO DRUG COVERAGE, AND ONLY SIX PAID DOCTOR VISITS A YEAR …. THE BENEFITS ARE SO SKIMPY THEY DON'T MEET THE MINIMUM LEGAL STANDARDS FOR MASSACHUSETTS. HAD CLOUTIER BOUGHT THE PLAN, THE STATE COULD HAVE PENALIZED HIM ANYWAY.
COAKLEY: we have been aware from the beginning that this is a problem that if we don't pay attention now could grow. .
MARTHA COAKLEY IS MASSACHUSETTS' ATTORNEY GENERAL.
MC: whenever you have a new law in effect & you have anything mandated, it's an opportunity for those who haven't sold products or services before, particularly health care, to come into a new market. there is a potential for people who are trying to cut corners, or trying to make money to do that.
LAST YEAR, 31-HUNDRED CONSUMERS CALLED THE ATTORNEY GENERAL'S OFFICE COMPLAINING OF HEALTH INSURANCE FRAUD -- INCLUDING DECEPTIVE ADVERTISING, AND MARKETING OF PLANS THAT DON'T MEET MASSACHUSETTS STANDARDS. COAKLEY FILED SUIT AGAINST TWO COMPANIES, HOPING TO SEND A MESSAGE TO OTHERS; MANY OTHER CASES WERE RESOLVED THROUGH MEDIATION.
BR: there are some really bad insurers out there, from out of state.
CONSUMER ADVOCATE BRIAN ROSMAN IS WITH BOSTON-BASED HEALTH CARE FOR ALL, WHICH WANTS TO SEE MASSACHUSETTS BECOME A NATIONAL MODEL FOR HEALTH REFORM. HE WORRIES THAT FLY-BY-NIGHT INSURANCE COMPANIES COULD DAMPEN SUPPORT FOR THE INSURANCE MANDATE, BUT HE SAYS THE NEW LAW ISN'T TO BLAME.
this was here before, this isn't a health reform issue. i think public education is the way to get at this problem.
STILL, WITH THE COST OF LEGITIMATE HEALTH PLANS SOARING, CONSUMERS REMAIN VULNERABLE TO OPPORTUNISTS.
BUSINESS OWNER GARY CLOUTIER IS STILL WITHOUT ANY HEALTH COVERAGE -- HE'S FOUND CHEAP PLANS, AND COMPREHENSIVE PLANS, BUT NEVER BOTH TOGETHER. SO HE CRUMPLES UP ALL THE OFFERS AND THROWS THEM AWAY.
I'M KAREN BROWN.