The Brief October 31, 2025<\/p>\n
How fake health insurance is luring people in, what to know about Andrew\u2019s Epstein fallout, and more<\/p>\n
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After a long career as a nurse, Lisa Bower, now 61, retired, started working as a part-time nanny, and, in 2021, realized she needed health insurance. The Illinois resident took to the Internet to sign up for a plan on the Affordable Care Act (ACA) marketplace. <\/p>\n
But something went wrong and she somehow ended up on another website that looked a lot like a health insurance marketplace. She entered her phone number and soon started getting calls and texts from people who wanted to help her get health insurance.\u00a0<\/p>\n
Within a few minutes, she was registered for a plan that she thought was ACA-compliant. But Bower had instead signed up for what\u2019s called a fixed indemnity plan, which is not actually health insurance and which just pays a small amount for covered services. She didn\u2019t realize that she didn\u2019t have proper health insurance until the fall of 2025, when her son was looking for a tax form that proved she had marketplace insurance and, unable to find it, started digging into her health care paperwork.<\/p>\n
Over three years, he found, she\u2019d paid about $16,000 to the fixed indemnity company while receiving very little benefit. During this time, she\u2019d paid out of pocket for costs like doctor\u2019s appointments and medications. Had she gotten an ACA-compliant plan, she probably wouldn\u2019t have had to pay much in premiums at all, her son says, because her low income would have qualified her for subsidies.\u00a0<\/p>\n
\u201cI did think at the time that it was less painful to sign up than I thought it would be,\u201d says Bower. \u201cI just chose what I thought was a cheap plan and didn\u2019t think much about it.\u201d\u00a0<\/p>\n
Bower\u2019s son, Jack, says that Illinois\u2019s real health care marketplace found evidence of Lisa starting to sign up in 2021, but says that she did not complete the application. Instead, he guesses, she got lured away by Google ads and ended up somewhere else.\u00a0<\/p>\n
\u201cI think she holds a third of the blame, and another third of the blame goes to this company that knowingly does this marketing to get people to pay for things they don\u2019t actually want,\u201d Jack says. \u201cBut the other third of the blame goes to our health care system, which is so complicated that companies just thrive in the confusion and an astute person can\u2019t make heads or tails of it.\u201d\u00a0<\/p>\n
The Bowers\u2019 experience is not particularly unusual. Confusion about navigating insurance writ large and the Affordable Care Act marketplace in particular has led many people to end up with plans that they think are health insurance which in fact are not health insurance. They mistakenly click away from healthcare.gov, the website where people are supposed to sign up for ACA-compliant plans, and end up on a site with a misleading name that may provide them with an ACA-compliant plan but also might not.<\/p>\n
Experts are predicting that this will happen to a larger degree when ACA open enrollment begins in most states on November 1. Because Congress did not extend enhanced premium tax credits, prices for ACA plans are going up an average of 75%<\/a>. This may spur more people to search for less expensive plans and end up with something that is not health insurance, whether they know it or not. <\/p>\n \u201cThere\u2019s no question that more people will end up with these kinds of plans if the premium tax credits are not extended,\u201d says Claire Heyison, senior policy analyst for health insurance and marketplace policy at the Center on Budget and Policy Priorities, a research and policy institute.<\/p>\n Read more: Why Your Health Insurance Costs Keep Rising<\/a><\/p>\n Under the Affordable Care Act, health insurance must cover 10 essential benefits<\/a>, including outpatient services, emergency services, maternity and newborn care, behavioral health treatment, prescription drugs, and pediatric services. But if people stray from the ACA marketplace, they can end up with plans that don\u2019t cover some\u2014or any\u2014of these essential health benefits. People may end up with short-term plans that don\u2019t last for a full year, or with the type of fixed indemnity plan that Bower got. Others may end up in health care sharing ministries<\/a>, in which people pitch in for other peoples\u2019 medical costs, but which sometimes do not cover preexisting conditions.\u00a0<\/p>\n These non-insurance products \u201chave increasingly been marketed in ways that make them look similar to health insurance,\u201d Heyison says. To stir further confusion, some even deploy common insurance terms like PPO (preferred provider organization) or co-pay in their terms and conditions. But people will pay a price for using them, Heyison says, because they can charge higher premiums than ACA-compliant plans, deny coverage based on pre-existing conditions, impose annual or lifetime limits on coverage, and exclude benefits like prescription drug coverage or maternity care.\u00a0<\/p>\n Often, the websites where people end up buying non-ACA compliant insurance have the names and logos of insurers on them. Sometimes, they are lead-generation sites\u2014like the one Lisa Bower mistakenly visited\u2014that ask for a person’s name and phone number and then share that information with brokers who get a commission for signing up people for plans, whether they are health insurance or not.\u00a0<\/p>\n \u201cThis can definitely happen if someone starts Googling and clicks on the first thing they see,\u201d says Louise Norris, health policy analyst at healthinsurance.org, an independent site providing information about insurance plans. \u201cPeople might not realize that what they\u2019re seeing isn\u2019t real health insurance.\u201d\u00a0<\/p>\n These mistakes are enabled by a legal gray area in which websites can imply that they can help people sign up for health insurance and then actually sign them up for something else. Brokers, who often work for particular health insurance companies, can often sign people up for both ACA-compliant plans and non-ACA compliant plans. But they typically get more money signing up someone for a non-ACA compliant plan than an ACA-compliant plan, says Heyison.\u00a0<\/p>\n Non-ACA compliant plans can spend more on administration costs like brokers and marketing because they aren\u2019t regulated in the same way as ACA-compliant plans and have more cash to spare. <\/p>\n Read more: Rising Health Care Costs Are the Real Reason for the Government Shutdown<\/a><\/p>\n Health insurance is complicated, and brokers exist to help walk people through the process of signing up for health insurance. But they sometimes don\u2019t have consumers\u2019 best interest at heart, says Emma Freer, senior policy analyst for the American Economic Liberties Project. \u201cIt\u2019s just very predatory because people clearly want information and guidance,\u201d she says, \u201cbut many middlemen are incentivized to operate with their own financial interest in mind, not the consumer\u2019s.\u201d\u00a0<\/p>\n There has been some legal action against companies who have represented what they\u2019re selling as health insurance, even though it\u2019s not. In May 2025, the U.S. Attorney\u2019s Office for the Eastern District of Pennsylvania charged four businessmen<\/a> and two companies with conspiracy and wire fraud offenses, alleging they had executed a national telemarketing fraud scheme in which they collected tens of millions of dollars by \u201csystematically deceiving and misleading consumers seeking health insurance through bait-and-switch sales tactics.\u201d And in August 2025, two companies agreed to pay a total of $145 million<\/a> to settle Federal Trade Commission charges that they deceived consumers into purchasing health care plans that did not provide the comprehensive coverage that was promised.\u00a0<\/p>\n But because many of these companies are actually offering products that are legal\u2014they just aren\u2019t comprehensive health insurance\u2014it can usually be difficult for people to recover any money, or to even get out of the plans. People who discover they signed up for the wrong plan during their state\u2019s open enrollment period should still be able to cancel the plan and sign up for real health insurance, says Heyison, of CBPP. But those who don\u2019t find out for months\u2014or years\u2014that they signed up for non-ACA compliant plans may have a harder time.<\/p>\n \u201cIt is definitely a situation where people need to pay close attention now, because in most cases you don\u2019t get a do-over,\u201d says Norris, of healthinsurance.org. <\/p>\n Brandon A., a 27-year-old Maryland resident, didn\u2019t have a lot of experience signing up for health insurance because he\u2019d been in the military and gotten health insurance there. When he went to research plans on the ACA marketplace in mid-October, he searched online for Maryland Health Connection, the state\u2019s marketplace, but ended up on marylandhealthcoverage.org instead.\u00a0<\/p>\n After entering his zip code and some personal information like his social security number, he got a quote for a plan. He also started getting bombarded with texts and phone calls from people who wanted to sign him up for health insurance. He chose a plan that was just a $300 deposit and $100 a month afterwards. After a few days, and checking with some friends, something seemed off to him, so he called the company back to cancel. They argued with him, telling him it was \u201cthe best healthcare nationwide,\u201d he says, but eventually allowed him to cancel the plan.\u00a0<\/p>\n In retrospect, Brandon, who didn\u2019t want his last name used because he\u2019s embarrassed about his error, saw that in the website\u2019s fine print at the very bottom, in very small text, it says it is not a federal or state health insurance marketplace. \u201cIt seems too easy for these sites to pose as real marketplaces,\u201d he says.\u00a0<\/p>\n Marylandhealthcoverage.org is operated by NextGen Leads, a lead-generation site that collects the information of people looking for health insurance and then charges companies for that information. It has more than 100 complaints on the Better Business Bureau of San Diego<\/a>, where the company\u2019s website says it is based. Many of the people filing these complaints say that they thought they were signing up for marketplace health insurance in states like Maryland and Georgia, entered their personal information on a site owned by NextGen Leads\u2014often with a domain name ending in .org\u2014 and then got spammed with hundreds of calls and texts from people trying to sell them health insurance products. \u201cTheir fraudulent website to mimic a health marketplace for [redacted] resulted in selling my information where now I received so many calls from spammers that I literally can not use my phone due to the insane amount of calls,\u201d one person wrote, in January 2025. The company did not reply to TIME’s request for comment. <\/p>\n Experts recommend that people who are stuck in plans that they didn\u2019t mean to buy contact their state insurance commissioner to report the problem. They should also contact a health care navigator or assister\u2014federally funded individuals who exist solely to provide unbiased information\u2014to see if they might qualify to sign up for a comprehensive health insurance plan through a special enrollment period because of a qualifying life event.\u00a0<\/p>\n Navigators and assisters are also helpful for those seeking new insurance, rather than engaging with brokers. Healthcare.gov is the best place for people to sign up for health insurance who want to do it on their own. Though about 20 states run their own marketplaces that use a different URL, healthcare.gov will direct them to the state marketplaces. It can also direct them to local assisters and navigators.<\/p>\n Signing up for a plan on the true ACA marketplace should not lead consumers to get bombarded with texts or calls\u2014if this happens to you, it probably means you ended up on a lead-generation site instead of on the real marketplace.<\/p>\n Heyison, of CBPP, recommends that consumers never rely on verbal promises that someone selling health insurance gives over the phone, they should instead ask for the plan documents. They should avoid companies offering an upfront gift for signing up, and ones that say that a certain price will only last a few days. Consumers should also spend a few days researching a plan, rather than buying the first thing they see, Heyison says. They should be looking for a plan on healthcare.gov<\/a> and one that is ACA-compliant.\u00a0<\/p>\n Some states are attempting to further regulate brokers and non-ACA compliant plans, Heyison says. In California, for instance, agents and brokers are required to assess people for Medicaid and the ACA\u2019s premium tax credit because they enroll them in health care sharing ministries, which could save them money by signing them up for government health insurance instead of a product that is not health insurance. And some states, including California, Illinois, and Massachusetts, prohibit the underwriting of short-term health insurance coverage, making it nearly impossible to sell non-ACA compliant plans in those states.\u00a0<\/p>\n But most other states haven\u2019t taken action, leaving people like Lisa Bower out of luck. Her son Jack tried to call the company that issued her indemnity plan and get a refund, but he knows he likely has no legal recourse. She should have read the paperwork more closely, they both admit. This year, they\u2019re ready for open enrollment\u2014and are determined not to look anywhere but healthcare.gov, the official Affordable Care Act marketplace. <\/p>\n","protected":false},"excerpt":{"rendered":"The Brief October 31, 2025 How fake health insurance is luring people in, what to know about Andrew\u2019s…\n","protected":false},"author":2,"featured_media":257030,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[49,48,84,5432,392],"class_list":["post-257029","post","type-post","status-publish","format-standard","has-post-thumbnail","category-healthcare","tag-ca","tag-canada","tag-health","tag-health-care","tag-healthcare"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/257029","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/comments?post=257029"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/257029\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media\/257030"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media?parent=257029"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/categories?post=257029"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/tags?post=257029"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}