Deception: Recipe for Surprise Medical Bills

When Americans pay good money for private health insurance, they expect their insurance company to pay their emergency medical bills. But insurers don't always pay. So how do they get away with it?

In the 2010 Patient Protection and Affordable Care Act (“Obamacare”), the federal government wanted to make sure that the law included protecting patients against emergency out-of-network bills. And it should come as no surprise, since this is the very essence of why people have health “insurance,” that insurers were supposed to pay. But powerful insurance interests pressured federal regulators to let them pay an amount based on how their plans determined out-of-network payments. This gave insurers a massive loophole — an escape clause that, shamefully, these schemers exploit to the maximum extent.

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