Congresswomen Deborah Ross (NC-02) and Kathy Castor (FL-14) introduced the bicameral Insurance Fraud Accountability Act, legislation to establish criminal penalties and enhance consumer protections against rogue health insurance brokers who are changing Americans’ Affordable Care Act (ACA) marketplace plans and disenrolling them from Medicaid without their knowledge or consent. Senator Ron Wyden (D-OR) introduced the Insurance Fraud Accountability Act in the Senate today. While Congressional Republicans are using allegations of fraud in the ACA as a pretense for not extending the enhanced ACA tax credits, this legislation takes meaningful steps to crack down on real, documented fraud.
The bill comes as the Centers for Medicare & Medicaid Services (CMS) has already begun undermining the ACA marketplaces by shortening the enrollment period, taking away financial assistance that lowers premiums, reducing benefits, and more.
“North Carolina families should never have to wake up to find their health insurance changed or cancelled without their knowledge,” said Congresswoman Ross. “I am proud to reintroduce necessary legislation that protects our communities from deceptive practices, holds bad actors responsible, and ensures every North Carolinian can trust that their health care decisions remain in their hands. While Republicans attempt to slash Americans’ health care, we are introducing a bill that would address tangible problems in our country’s health care system.”
“The best way to fight fraud is to go after fraudsters, not punish Americans trying to get affordable health care,” said Senator Wyden. “Working families need to be able to confidently purchase quality, affordable health insurance through honest brokers. Bad actors who are undermining that confidence must be held criminally responsible. Republicans have been talking a lot about waste, fraud, and abuse lately - this legislation is a great place to start rather than taking away health insurance from working Americans and increasing premiums for millions of families.”
"The Affordable Care Act (ACA) has been a godsend to families across America and in Florida, which has the highest number of marketplace enrollees nationwide. The ACA has lowered the cost of high quality health care and banned discrimination for preexisting conditions. Unfortunately, a few bad actors are exploiting people and signing them up for health insurance plans without their consent,” said Congresswoman Castor. "I’m proud to introduce the Insurance Fraud Accountability Act with Senator Wyden and Rep. Ross to bring greater transparency and accountability to the health insurance marketplace by cracking down on predatory health insurance sales, ensuring consumers are notified of plan changes, establishing stronger penalties for fraudulent enrollments and requiring brokers to act in the best interest of the customer. Together, these measures will protect hardworking Americans from predatory practices and keep money in their wallets where it rightfully belongs. If President Trump and Congressional Republicans were serious about addressing fraud in our health systems, they would support this critical legislation.”
This legislation will impose criminal penalties for agents and brokers who engage in fraudulent practices, including enrolling individuals in plans without their consent and using deceptive marketing to target vulnerable groups. To further protect consumers, the legislation will create a consent verification process, ensuring that individuals will be kept informed of any new enrollments or changes to their insurance coverage. This comprehensive approach aims to strengthen accountability and transparency in the health insurance industry.
The bill is endorsed by AHIP, AiArthritis, American Cancer Society Cancer Action Network, American Kidney Fund, American Lung Association, Arthritis Foundation, Autoimmune Association, Blue Cross Blue Shield of America, Cambia, CancerCare, Centene Corporation, Crohn's & Colitis Foundation, Cystic Fibrosis Foundation, eHealth, Epilepsy Foundation of America, Families USA, Hemophilia Federation of America, Immune Deficiency Foundation, Leukemia & Lymphoma Society, Lupus Foundation of America, Muscular Dystrophy Association, National Alliance on Mental Illness (NAMI), National Coalition for Cancer Survivorship, National Health Council, National Kidney Foundation, National Multiple Sclerosis Society, National Organization for Rare Disorders, National Patient Advocate Foundation, Quote Velocity, Susan G. Komen, The AIDS Institute, The Leukemia & Lymphoma Society, and UnidosUS.
Bill text is available here and a one pager is available here.