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White House initiative to prevent and detect fraud in health insurance marketplaces

Wednesday, September 18, 2013

White House Initiative to Prevent and Detect Fraud in Health Insurance Marketplaces: Consumers Union Statement

WASHINGTON, DC – The White House today announced an interagency initiative to protect consumers from being victims of fraud while using the upcoming Health Insurance Marketplaces, including a way for consumers to report fraud through the Marketplace call centers.

DeAnn Friedholm, Director of Health Reform for Consumers Union, the policy and advocacy division of Consumer Reports, praised the commitment to preventing fraud and taking action against those connected with scams, while reinforcing the need for education to help consumers avoid these pitfalls.

Friedholm said, “Every new program presents an opportunity for scammers to try to take unfair advantage of consumers and these health insurance marketplaces are no different. That’s why this type of fraud prevention and detection is critical to ensuring that consumers know that they can turn to the marketplaces to get the coverage they need without hesitation. While some attempt to undermine the law and make it difficult for community groups to assist consumers through the Navigator program, these safeguards announced today work to ensure that consumers can take advantage of the benefits of the Affordable Care Act without being taken advantage of. It’s also important that we arm consumers with the information to spot, avoid and report scams before they take place.”

In addition to utilizing the initiatives announced today by Attorney General Eric Holder, Health and Human Services (HHS) Secretary Kathleen Sebelius, and Federal Trade Commission (FTC) Chairwoman Edith Ramirez, Consumers Union has outlined tips for consumers to help:

1.       Don’t pay anyone for help getting health insurance—Navigators and other Marketplace assisters should be free

2.       Ask for proof of certification as a Navigator

3.       Don’t respond to unsolicited pitches or calls and refuse to provide any personal information.

4.       Only use the official Marketplace web site or call number.

5.       Always be skeptical of high pressure tactics — hang up if someone calls you unsolicited, close the door or walk away if you’re approached by someone asking for money to help you enroll.


Contact:  David Butler, dbutler@consumer.org, or Kara Kelber, kkelber@consumer.org202-462-6262