The Issue With Nixing the Affordable Care Act That No One Is Talking About

Without a replacement, millions Americans will lose health insurance — and that creates a moral hazard. Here's how.

Never mind his crowd-favorite pledge to build the Great Wall of Mexico with a “big, fat door,” President Donald Trump’s cornucopia of campaign promises included many a forgettable vow. But you had to be whale-spotting from a lily pad on Loon Lake to miss the president’s pledge to repeal the Affordable Care Act (ACA).

What may not be as obvious is the effect that such a move could have on crime — specifically medical identity theft.

Promises are often downgraded to “ideas” post-victory, but now that Candidate Trump is leader of the free world, it’s time to revisit this major pledge. One of the first things our new president did Friday was sign an executive order urging his administration to fight the ACA.

The executive order has no teeth. It simply states the Trump administration’s position, and, sure, that carries with it all the heft brought to bear by the Oval Office. But what is worrisome for proponents of the ACA is that the executive order follows current legislative efforts in Congress to obliterate the centerpiece of President Barack Obama’s legacy. With a newly installed majority, Republicans are poised to dismantle the historic law that helped 20 million uninsured Americans get affordable healthcare. Most recently, in a 227 to 198 vote, members of the House approved a budget that would kill major provisions of the ACA.

“This is a critical first step toward delivering relief to Americans who are struggling under this law,” House Speaker Paul Ryan said last week.

It’s hard to say exactly how many Americans would lose their health insurance should Obamacare go away, since Republicans have yet to outline a plan to replace it. However, a recent study from the non-partisan Congressional Budget Office (CBO) found a straight-up repeal would leave about 18 million people uninsured the following year.

It goes without saying the majority of those affected will not resort to a life of crime in order to acquire healthcare. In fact, it is unlikely, but should Congress, in concert with the Trump administration, repeal the ACA without providing a viable alternative, the sheer number of uninsured people will create a moral hazard — crimes will become a possibility where they would not have been — and this can only result in an uptick in the medical identity theft numbers.

What Is Medical Identity Theft?

As I explain in my book, Swiped: How to Protect Yourself in a World Full of Scammers, Phishers and Identity Thieves, medical identity theft is widespread, and potentially deadly.

While there is a long and sordid history of organized crime running healthcare-related scams whereby crooked doctors and garden-variety crooks team up to defraud insurers or get prescriptions for controlled substances that are then sold for recreational use, the theft of one person’s healthcare by another is a very real thing, and it can be life threatening.

Your medical records provide information that can be used in a variety of ways. For instance, once a criminal has your personal information and insurance details, he or she can use it, or enable another person to use it to gain access to the healthcare system in your name, and the result could be the contamination of your medical records with his or her co-mingled information.

Nothing is more dangerous than going to a hospital and having “your” medical records, as used by an identity thief or his/her “customer,” reflect an inaccurate blood type, medical history, or the existence or absence of certain allergies when you are receiving medical care, particularly in an emergency situation.

Another result of medical identity theft can be denial of service. If an impostor uses your insurance to gain access to healthcare, it can affect your own ability to access care: Many insurance plans have annual caps on certain types of procedures and treatments — and obviously no insurance company is going to pay for one person to have an appendectomy twice. An identity thief with access to your insurance could drain your coverage before you even know it’s happened and leave you in the lurch when you need it.

How to Prevent Medical Identity Theft

There are ways to defend against medical identity theft. Most involve proactive monitoring of your medical files. Many larger medical providers permit you to review your medical records by way of a secure website. If your doctor doesn’t offer such a service, you should sit with him, her or their staff at least once per year and review your files to confirm their accuracy. In addition, you should intently review any correspondence you receive from your health insurer, particularly Explanation of Benefit Notices, which will be the most immediate way to discover theft of services.

You should also review your credit reports at least once a year at AnnualCreditReport.com to make sure that all information is accurate. If you notice anything involving medical debt or a collection relating to a medical bill that is news to you, confirm its accuracy and that it’s not an indication you are a victim of medical identity theft.

You might also wish to keep track of your credit scores. Any sudden, unexplained drop could indicate a problem, and that issue might stem from medical identity theft. (You can view two of your free credit scores, updated every 14 days, on Credit.com.)

As for threats to the ACA, nothing has happened … yet. Lawmakers are still trying to figure out how to approach their stated goal of repealing Obamacare, and it won’t be easy. If you have concerns, you can call Speaker Ryan and other lawmakers who have vowed to do away with the ACA. As for the stated goal of repealing the ACA: An ounce of caution may be worth a pound of cure.

This story is an Op/Ed contribution to Credit.com and does not necessarily represent the views of the company or its partners.

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You Aren’t the Only One Who Knows What Meds You’re On

prescription-data-privacy

Most people expect their medical data to remain in just a few hands — their doctor, their pharmacist, their family, etc. — but prescription medication data can be shared with a number of companies you may not expect.

Consumer Reports reminded readers last week that prescription drug data can be shared not only with your pharmacist, but with the pharmacy chain, data miners and insurance companies. These companies use the data to send you ads for medical supplies you may need, like a new blood pressure monitor if you have hypertension, to understand how healthy you are for actuarial insurance reasons and even to do medical research. HIPAA, the Health Insurance Portability and Accountability Act, places certain restrictions on how the data can be used and is intended to protect consumers’ privacy. Your prescription information is often separated from your name and other personal information so that the data can be used, but you won’t be identifiable.

You also have some rights when it comes to knowing the medical information that’s being shared about you. You may be able to opt out of marketing programs when signing up at a pharmacy chain or when filling out new patient paperwork at your doctor’s office. You also can check your medical data reports to make sure they’re accurate. They can give you a good sense of what information is being shared about you:

  • Medical Information Bureau (MIB): 866-692-6901
  • MedPoint: 844-225-8047
  • Milliman Intelliscript: 877-211-4816

Why Does My Medical Data Matter?

Checking your medical data reports might seem like overkill — after all, you have your own medical records, you know your own medical history, why do you need to see these reports?

First off, there’s a data protection issue. Some of the major pharmacy chains in the United States have undergone data breaches in recent years, and protecting your medical data can be a life-and-death matter, quite literally. Incorrect medical data can lead a hospital employee to administer the wrong type blood in an emergency situation, for example.

Second, if your file contains information that belongs to another person, perhaps giving you a chronic (and expensive) illness you don’t actually have, you could also face higher insurance costs when you shop for life insurance. Medical data reports are just like credit reports — mistakes happen and you can fix them if you stay vigilant. (You can check your credit reports for free once a year to make sure they’re accurate and check your credit scores for free on Credit.com monthly to spot any changes that may signal an error.)

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5 Ways Identity Theft Totally Screws Up Your Life

identity theft

Identity theft is on the rise in the United States — at least reports of identity theft are way up — and oftentimes, people don’t realize they’re victims until a thief has already made a mess of things.

Some of those messes are more challenging to clean up than others. It sometimes takes years to repair the damage done by identity thieves, and unfortunately, it’s very difficult to prevent it from happening in the first place. Data breaches, security flaws and human errors expose people’s personal information all the time, and there’s often no way of knowing if yours has been compromised until it’s too late.

You can freeze your credit to prevent someone from opening fraudulent accounts in your name (it often carries a fee, depending on where you live), but beyond that, one of the best things you can do to protect yourself from the abuse of an identity thief is to regularly check your credit for signs of fraud. You can spot sudden, unexpected changes in your free credit report summary, which is updated every month on Credit.com, and as soon as you identity something suspicious, act quickly to minimize the damage. The sooner you can figure out what’s going on, the better — identity theft can be quite destructive. Here are some examples of how.

1. Lost Benefits

The way someone abuses your personal information can seriously disrupt your way of life. In 2015, a Tennessee woman found out her Social Security disability check — her sole income — had been canceled because someone had filed a fraudulent tax return with her Social Security number. That fake return led the Social Security Administration to think she had lied about being disabled to the point of being unable to work, even though the IRS had confirmed she was a victim of identity theft.

You could find yourself in a similar situation if you’re a victim of medical identity theft. If someone fraudulently claims your insurance benefits, there might not be anything left for you and your medical needs.

2. Troubles With the Law

Even if you’ve never had run-ins with the law, you could end up with some sort of criminal record, thanks to an identity thief. Jessamyn Lovell found out someone had stolen her identity after the thief was arrested, but that was only the beginning of the issue for Lovell. She received a court summons for crimes the thief had committed in her name, and Lovell had to spend the time and money to make the court appearance and prove she hadn’t done any of the things her name had been fraudulently attached to.

3. Mistakes on Your Credit Report

New account fraud is a common form of identity theft: Someone gets their hands on your Social Security number and uses it to borrow money or open a credit card they never intend to repay. Since the accounts use your Social Security number, they’ll likely end up on your credit report, and that information (which is probably negative) will factor into your credit scores. That’s why a sudden drop in your credit scores could be a sign of identity theft. A credit freeze can prevent new account fraud, but it doesn’t prevent someone from taking over and abusing your current accounts. Even if you have a freeze in place, it’s important to monitor your credit for suspicious activity.

Finding the problem is only the beginning — then you need to fix the errors on your credit report. You can do this by disputing the information with the credit bureaus yourself, but if you have trouble resolving the issues or are overwhelmed by the process, you can also hire someone to help you repair your credit for a fee.

4. Family Drama

You may never find out who the shady character is behind your identity theft — or you could know them all too well. It’s common for identity theft to occur within families, as parents, children and other relatives often have access to each other’s personal information. Sometimes, it happens when a parent has ruined their credit and decides to get a fresh start using a child’s blank slate of a credit report. That robs the victim of the chance to establish their own credit, potentially leaving them to start their adult financial lives with years of a negative credit history they had nothing to do with. Reversing the damage of identity theft generally requires reporting the crime to the police, and people aren’t always willing to do that to their families, even when they’ve been wronged.

5. Messy Taxes

Taxpayer identity theft means someone stole your Social Security number and filed a fraudulent tax return to get a refund before you had a chance to file yours. Of course, you still have to do your taxes, but you’re going to have to do them by hand, and don’t expect a swift refund if you’re owed one. A typical case of taxpayer identity theft can take 180 days to resolve, according to the Internal Revenue Service.

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