High-Pressure Sales Tactics of Health Care Programs Assailed

State officials voiced outrage Tuesday at high-pressure marketing techniques used by door-to-door salespeople to enroll Medi-Cal patients in private health care plans, and a state assemblyman said he will introduce a bill to ban the practice.

“Some bad actor sales people” have victimized Medi-Cal beneficiaries, said John Rodriguez, deputy director of programs for the state Department of Health Services. But instead of banning door-to-door sales, he said, salespeople should be closely monitored to prevent abuses.

About 82% of people enrolled in private, managed health plans are signed up by door-to-door salespeople.

Responding to complaints published Monday by The Times, Assemblyman Burt Margolin (D-Los Angeles) said he will move to prohibit door-to-door marketing of private health plans. “There is clear evidence we need to ban this practice,” he said.

A spokesman for state Sen. Diane E. Watson (D-Los Angeles), who chairs the Senate Health & Human Services Committee, said Tuesday Watson plans to amend pending legislation to require licensing of door-to-door salespeople and establish standards that they must meet.

Complaints about door-to-door sales have arisen as a result of a major statewide policy change aimed at shifting hundreds of thousands of low-income Californians out of the government-sponsored Medi-Cal program into private, managed health care plans, such as health maintenance organizations.

For a monthly fee, the state health department contracts with prepaid health plans to provide care for low-income people, who typically have difficulty finding private practitioners to treat them.

The program is part of a long-term strategy that California, like many other states, is hoping will overhaul the delivery and financing of health services for the poor in hopes of improving access and reducing costs.

Unlike most states, California permits private health plans to employ door-to-door salespeople.

Critics say this has led to widespread abuses, as competing health plans have unleashed squadrons of high-pressure marketing agents, paid on commission, to sell various health care plans to people who often do not understand the consequences of their choices.