Health Insurers Discussed Delaying Covering Children with Pre-Existing Conditions

by LAS

According to a March 28 story in the New York Times, and just days after President Obama signed the historic healthcare bill into law, insurance companies were insistent that they did not have to provide coverage to children with pre-existing conditions. President Obama called that element of the healthcare bill a 'centerpiece' of the new law.

President Obama, speaking at a rally in Virginia on March 19, said, “Starting this year, insurance companies will be banned forever from denying coverage to children with pre-existing conditions.”

This provision of the reform bill was meant to protect youngsters who suffer from conditions such as leukemia, cystic fibrosis, birth defects, sickle cell disease, etc from being denied coverage under current business practices.

But the insurance industry tries to redefine what 'is' is, and what 'coverage' and 'insurance' mean.

While insurers agree that if they write a policy for a child, that they must cover pre-existing conditions. However, they still feel that they are not compelled to write a policy for a given child, and that at any rate this provision does not go into effect until 2014.

A few days after expressing their reluctance to implement this provision of the healthcare reform bill, the industry was compelled to announce that they would, in fact, observe this feature of the new law. But that came only after public outrage at insurance industry statements, including criticism from Senator John D. Rockefeller, among others.

According to the New York Times: Senator John D. Rockefeller IV, Democrat of West Virginia and chairman of the Senate commerce committee, said: “The ink has not yet dried on the health care reform bill, and already some deplorable health insurance companies are trying to duck away from covering children with pre-existing conditions. This is outrageous.”

The new law says that health plans and insurers offering individual or group coverage “may not impose any pre-existing condition exclusion with respect to such plan or coverage” for children under 19, starting in “plan years” that begin on or after Sept. 23, 2010.

But, insurers say, until 2014, the law does not require them to write insurance at all for the child or the family. In the language of insurance, the law does not include a “guaranteed issue” requirement before then. This is what ignited the firestorm of protest and criticism from those in Congress and the reform movement.

SOURCE:
Pear, Robert, Coverage Now for Sick Children? Check Fine Print, March 28, 2010, New York Times, http://www.nytimes.com/2010/03/29/health/policy/29health.html