The Houston MetroHealth Partnership (HMPP) filed a class-action lawsuit against Texas Health Partners on Monday, alleging the health insurer discriminated against them and others in its health plans and policies for medical coverage.
The lawsuit, which seeks a total of $4.3 billion in damages, alleges that health plans were structured to benefit certain groups, including those with pre-existing conditions and low incomes.
It also alleged that plans gave consumers misleading information about how the plan would work and that the companies did not fully disclose that certain benefits would not be available to the vast majority of plans.
“The plaintiffs allege that the health plans failed to provide adequate, timely and comprehensive coverage and that they discriminated against the plaintiffs in violation of the Americans with Disabilities Act, which prohibits discrimination on the basis of disability,” the lawsuit reads.
The complaint alleges that the policies that HMPP enrolled in were marketed to people with pre or milder medical conditions.
The lawsuit claims that plans offered more generous benefits than they did under the ACA, including maternity and paternity coverage, and coverage for emergency room visits.
“These plans, as well as others that the plaintiffs have enrolled in, are subject to federal, state and local laws, and plaintiffs are currently attempting to pursue a federal class action on behalf of the entire class,” the complaint states.HMPP, a nonprofit health insurance company, said in a statement that it “stands by the claims in the lawsuit.”
“We have an equal opportunity policy and are committed to providing health plans that meet our needs and meet our clients’ needs,” the statement reads.
“As we have said many times, we do not discriminate in the coverage of health benefits, and we will continue to aggressively defend the claims against us.”
According to the lawsuit, the Texas plans had different policies for people who were insured in another state.
It said that in addition to the pre-ACA plans, the plans offered policies that had lower deductibles, more frequent out-of-pocket expenses, and reduced or no premium tax credits.
The plan’s lawsuit also alleges that Texas Health plans were less than fair to its members, and that many people were charged more than they should have been for coverage.
It also said that the plans had discriminatory policies in other states that excluded some health insurance coverage, including plans that had high deductibles.
The group also said in the suit that the ACA’s protections against discrimination were too limited and lacked sufficient teeth.
“We are disappointed with the outcome, and believe that the lawsuit will ultimately allow the plaintiffs to get to the bottom of this issue,” the group said in an emailed statement.
“Our lawyers and the attorneys for our customers will continue fighting for the rights of Texans with pre and milder conditions.”
The group’s attorneys have filed a motion to dismiss the case.
The complaint, which claims to have more than 40 claims, was filed in federal court in Houston.