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Health plans trying to reach low-income and underserved customers say they’re being stymied by a decades-old federal rule limiting texting — and they’re framing it as a health equity issue in their bid to change it. 

Low-income and underserved patients, they say, are more likely to see and respond to texts about their health than they are to answer calls from unknown numbers or to receive mailed notices, especially if they’re at work or move frequently. But a 1991 law designed to protect consumers from unwanted telemarketing blocks health plans contracting with Medicaid from texting patients without their prior consent, meaning that they can’t send reminders about services like mammograms or well-child visits unless they’ve reached the patient by phone or mail first. 

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