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Comment by levocardia | Hacker News Reader

The actual "sharing" was using the Meta pixel and TikTok's equivalent, presumably so the healthcare exchanges could do retargeting or similarity-based marketing to get people to sign up for health care coverage. Which, narrowly, seems like a reasonable thing to do. But of course using the pixel automatically "shares" the data with Meta/ByteDance/whoever, and they get to use it for whatever nefarious purpose they want.

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The state healthcare exchanges doing any kind of targeting and/or marketing, even to 'get people' to sign up for subsidized healthcare, could also be conceived of as unreasonable. I could be wrong, but I wouldn't think their mandate under the ACA contemplates any targeting or marketing of themselves whatsoever—even if it's ostensibly to increase enrollment.

That it feels like there's an implicit assumption that they would (target or market) seems to be part of the problem.

> could also be conceived of as unreasonable

It could also be conceived of as perfectly reasonable. One of the many (some very flawed) purposes of the ACA was to get more people insured, advertising that state-subsidized insurance is available for you is absolutely in that wheelhouse.

If retargeting is the problem, it should be banned across the board, both for public and private ad campaigns.

What was that saying about paving the roads to hell?

Nefarious indeed. Once they know who you are, they match you against insurance industry databases and can infer many health conditions and other stuff.

If you’re timely with prenatal care, marketers can predict a woman’s delivery data within a week with high confidence.

Obamacare banned insurer price discrimination for pre-existing conditions.

They sell the data for marketing other products.

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