During open enrollment, ads from telemarketers are crowding out official health exchanges.<\/p>\n
November 22, 2025 at 6:00 AM EST<\/p>\n
Corrected on November 22, 2025 at 6:45 PM EST<\/p>\n
Over the next few weeks, millions of Americans will shop for health insurance online. Many will find comprehensive plans through Affordable Care Act marketplaces like HealthCare.gov<\/a>. Others will be steered elsewhere \u2014 toward insurance products that sound great but don\u2019t provide much coverage.<\/p>\n For many buyers, the trouble starts with a Google search, where the first click on a results page can be the difference between getting the coverage they need \u2014 and getting ripped off.<\/p>\n Here\u2019s what can happen:<\/p>\n For consumers, this hodgepodge of official and commercial sites can be confusing. Every year, Americans all over the country file complaints to the Federal Trade Commission, the Better Business Bureau and other consumer review sites, claiming they were misled while shopping for health insurance online.<\/p>\n They report being steered by Alphabet Inc.<\/a>-owned Google to a commercial website, leading to a phone call with a salesperson. Then they\u2019re talked into buying \u201climited\u2011benefit\u201d or short\u2011term products with little to no coverage \u2014 what health policy experts<\/a> call \u201cjunk insurance.\u201d These alternative plans often fail to cover crucial benefits such as hospital stays or emergency-room visits. They may also exclude coverage for preexisting conditions entirely.<\/p>\n In one complaint to the FTC last year, a parent from Coarsegold, California, said their daughter needed weekly allergy shots. Searching Google for health insurance, the parent wrote, they clicked on a link that looked like HealthCare.gov.<\/p>\n The parent entered a phone number on a website and bought a $530-a-month insurance policy from the salesman who followed up, according to the complaint. Months later, the parent learned it was a limited-benefit plan that didn\u2019t meet ACA standards. The family was stuck with bills for multiple allergist visits.<\/p>\n \u201cI am livid!!!!!,\u201d wrote the parent, whose name wasn\u2019t disclosed by the FTC. \u201cMy daughter is in the middle of treatment that is now stopped!\u201d<\/p>\n That experience echoes dozens of similar complaints that Bloomberg News obtained from the FTC via public-records requests:<\/p>\n Bloomberg News wanted to better understand how consumers can be misled when searching for health insurance. Google considers its search engine algorithms proprietary information and specific ranking details are rarely publicly disclosed. So, we decided to test the process ourselves.<\/p>\n During the first 10 days of open enrollment \u2014 Nov. 1 to Nov. 10 \u2014 we ran more than 4,800 Google searches across all 50 states using health-insurance-related terms such as \u201cObamacare,\u201d \u201cACA marketplace\u201d and \u201ccheap health plans.\u201d<\/p>\n After adjusting the results for state population, a clear pattern emerged: on Google, official state or federal exchanges take a back seat to for-profit marketing companies. These advertisers are mostly insurance call centers and lead generators \u2014 the online middlemen who connect customers with the centers. Official sites appeared as the first result only a quarter of the time, and somewhere in the top three 40% of the time. The marketing companies occupied more than half of the top-three spots.<\/p>\n Health-Care Hustlers<\/p>\n This story is the third in a series about the shady side of health-care telemarketing.<\/p>\n Part One: Health-Care Plans Built on Fake-Job Loophole Threaten Obamacare<\/a><\/p>\n Part Two: Celebrity Deepfakes Supercharged a Florida Health-Care Scheme<\/a><\/p>\n This might come as no surprise; advertising is what keeps Google search free. When people look for cruise trips or refrigerators, they expect to see ads from companies selling those products.<\/p>\n But health insurance searches are different. Official government marketplaces can help most people get ACA plans, but don\u2019t spend much on ads. Instead, the first links shoppers typically see are from for-profit companies \u2014 often imitating official sites \u2014 that might steer them toward non-ACA products that are more profitable to sell.<\/p>\n For-Profit Call Centers Dominate Google Search Results<\/p>\n Share of top-three positions on Google search result pages for “health insurance” and similar terms<\/p>\n \u201cOur search ranking systems ensure that official resources rank highly for the vast majority of health insurance queries,\u201d Nate Funkhouser, a Google spokesman, said in a statement. Ads are prominently labeled, he added, and advertisers offering ACA policies are required to prove they\u2019re authorized by state and federal regulators to sell such products.<\/p>\n Funkhouser said Bloomberg used a \u201cquestionable methodology\u201d and relied on a tiny fraction of the billions of queries Google handles each day. He said Google removed some ads in response to Bloomberg\u2019s inquiry without specifying which ones.<\/p>\n Still, the results of Bloomberg\u2019s analysis show that official health-care exchanges are rarely the first thing customers will see on Google. More often, they\u2019re the fifth or sixth link on the page. Research shows users are less likely to click on a link that\u2019s labeled as sponsored, but only half of search engine users are able to correctly identify sponsored links<\/a>.<\/p>\n \u201cWe make it clear to users which results are sponsored, so equating ads and organic search results does not reflect the user experience,\u201d Funkhouser said. He also pointed to Google\u2019s use of AI overviews to surface credible information, and said finance-related queries have \u201can even higher bar for showing supporting information from reliable and trustworthy sources.\u201d<\/p>\n Google\u2019s AI overviews were more likely to point to official sites like healthcare.gov and state exchanges, Bloomberg\u2019s analysis found. However, the AI summaries appeared at the top of the search page less than 20% of the time in our results \u2014 more often, they appeared below paid advertisements.<\/p>\n Where Official Insurance Marketplaces Appear in Google Results <\/p>\n Chance of an official site, such as healthcare.gov or a state marketplace, appearing in each of the top 10 spots in Google search results. <\/p>\n Google requires advertisers to accurately represent their services, avoid implying any government affiliation and include disclaimers if they are not official exchanges.<\/p>\n Organic search results and paid advertisements run on different systems. Organic rankings are based on Google\u2019s algorithm, which weighs relevance and page quality. Ads are ranked based on a different system that includes how relevant they are and the amount an advertiser is willing to pay.<\/p>\n Bloomberg\u2019s analysis found that Google\u2019s system showed ads first in a majority of searches, allowing marketers who might steer shoppers toward non-ACA products to crowd out the organic search results that send users to official websites.<\/p>\n \u201cThey will let a company who has 5,000 one-star reviews appear as #1 as long as they pay the most,\u201d said Eugene Tolkachev, who runs a call center that\u2019s a top Google advertiser, in an email. The result, he said, is \u201can unfair marketplace to good actors.\u201d<\/p>\n Google does consider information like consumer reviews and regulatory warnings in determining whether an advertiser is violating its policies, Funkhouser said.<\/p>\n The stakes for consumers during this year\u2019s open enrollment season are particularly high. Out-of-pocket costs for many ACA policyholders are set to more than double next year because of a drop in government subsidies. That could cause the uninsured population to rise by 2.2 million next year, the Congressional Budget Office estimates.<\/p>\n Tolkachev\u2019s company, Acme Health and Life, is based in South Florida, the capital of the health-insurance telemarketing industry. In hundreds of call centers, mostly in and around Fort Lauderdale, salespeople pitch a mix of ACA-compliant plans and less-comprehensive products, such as short-term and fixed indemnity policies.<\/p>\n There\u2019s nothing inherently wrong with selling low-benefit plans, as long as customers understand what they\u2019re buying. Some policymakers<\/a> and industry professionals say these alternatives fill an important niche, especially for younger, healthier people who don\u2019t expect major medical costs and earn too much to qualify for subsidies. Outside of open-enrollment periods, some consumers also may not be eligible to buy an ACA plan.<\/p>\n Acme strives to sell products that best fit the customer\u2019s circumstances and to ensure they understand what they\u2019re buying, Tolkachev said.<\/p>\n But other South Florida telemarketers have been caught tricking customers into buying low-benefit plans that pay higher commissions. In 2018, the FTC accused <\/a>Steven Dorfman \u2014 a Lamborghini-driving call center boss in Fort Lauderdale \u2014 of systematically deceiving customers by promising Obamacare coverage while selling what the government called \u201csham\u201d insurance. He is currently serving a 25-year prison sentence from a related criminal case.<\/p>\n In 2022, a marketing firm that worked with Dorfman\u2019s call center and dozens of others in the area agreed to pay $100 million<\/a> in customer refunds after the FTC alleged similar practices.<\/p>\n More recently, the FTC investigated MediaAlpha Inc., historically one of Google\u2019s biggest health-insurance advertisers and a major lead supplier to South Florida call centers. In a court complaint, the agency said<\/a> MediaAlpha spent millions of dollars on deceptive Google ads that directed consumers to websites mimicking official ACA marketplaces. Those sites then funneled consumers to call centers that sold inferior products, according to the FTC.<\/p>\n The complaint highlighted two sites, obamacare-plans.com and obamacareplans.com, that it portrayed as particularly misleading. SpyFu, a search analytics firm, estimates the two websites together had a monthly Google Ads budget exceeding $1.8 million.<\/p>\n This past August, MediaAlpha agreed to pay $45 million to settle the lawsuit. The company didn\u2019t admit wrongdoing, and its chief executive officer later said \u201cwe strongly disagree\u201d with the allegations. MediaAlpha declined to comment further to Bloomberg. As part of the settlement, it also agreed to stop using the \u201cObamacare\u201d web addresses.<\/p>\n But that hasn\u2019t stopped other advertisers from using similar tactics nor has Google intervened. Among our search results were five websites with \u201cObamacare\u201d in their names.<\/p>\n \u201cAs far as the search terms go, I wouldn\u2019t say it\u2019s misleading\u2026 That\u2019s something that people just generally search for,\u201d said John Medina, a partner at Miami-based First Health Solution LLC, which operates ObamaCare-Enroll.org and is an affiliate of the owner of Obamacareplans.org. Medina said his agents sell both limited-benefit plans and ACA policies but always try to serve the client\u2019s best interest.<\/p>\n \u201cObamacare isn\u2019t an official term by the government,\u201d Medina added. \u201cIt\u2019s a term made up by the media.\u201d<\/p>\n That kind of ambiguity around language has long fueled confusion in online health insurance searches. In 2019, Democrat Bob Casey<\/a>, then a US senator from Pennsylvania, published a report<\/a> faulting search engines for allowing what he called \u201chealth care sabotage,\u201d including permitting private advertisers to use \u201chealthcare.gov\u201d in marketing copy.<\/p>\n