Discount medical cards have come under increasing scrutiny by regulators and law enforcement officials as a result of mounting consumer-reported problems. For their study, the authors tested five cards available in the Washington, D.C., metro area; interviewed card company representatives, state attorneys general insurance regulators, and insurance agents; and reviewed court and administrative actions. While some cards provide a measure of value, other cards were found to have serious drawbacks, including: high-pressure sales tactics; misleading or inaccurate promotion; exaggerated claims of savings; difficulty finding participating doctors; and providers who failed to give cardholders promised discounts. Some discount card companies are seeking to reform the market through a trade association and voluntary code of conduct. Still, legislative and regulatory interventions will be needed to protect consumers in an unregulated and growing market.