Coverage Now for Sick Children? Check Fine Print
By ROBERT PEAR
NYT
WASHINGTON — Just days after President Obama signed the new health care law, insurance companies are already arguing that, at least for now, they do not have to provide one of the benefits that the president calls a centerpiece of the law: coverage for certain children with pre-existing conditions.
Mr. Obama, speaking at a health care rally in northern Virginia on March 19, said, “Starting this year, insurance companies will be banned forever from denying coverage to children with pre-existing conditions.”
The authors of the law say they meant to ban all forms of discrimination against children with pre-existing conditions like asthma, diabetes, birth defects, orthopedic problems, leukemia, cystic fibrosis and sickle cell disease. The goal, they say, was to provide those youngsters with access to insurance and to a full range of benefits once they are in a health plan.
To insurance companies, the language of the law is not so clear.
(More here.)
NYT
WASHINGTON — Just days after President Obama signed the new health care law, insurance companies are already arguing that, at least for now, they do not have to provide one of the benefits that the president calls a centerpiece of the law: coverage for certain children with pre-existing conditions.
Mr. Obama, speaking at a health care rally in northern Virginia on March 19, said, “Starting this year, insurance companies will be banned forever from denying coverage to children with pre-existing conditions.”
The authors of the law say they meant to ban all forms of discrimination against children with pre-existing conditions like asthma, diabetes, birth defects, orthopedic problems, leukemia, cystic fibrosis and sickle cell disease. The goal, they say, was to provide those youngsters with access to insurance and to a full range of benefits once they are in a health plan.
To insurance companies, the language of the law is not so clear.
(More here.)
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2 Comments:
FYI : During the final re-vote, John Kline used this storyline to try once more to kill the bill ... and sent out a press release for his constinuents to know about it.
Yet, he failed to acknowledge that it’s a matter of interpreting the legislation and that Health and Human Services Secretary Kathleen Sebelius would try to resolve the situation by issuing new regulations. “To ensure that there is no ambiguity on this point, the secretary of HHS is preparing to issue regulations next month making it clear that the term ‘pre-existing exclusion’ applies to both a child’s access to a plan and his or her benefits once he or she is in the plan for all plans newly sold in this country six months from today,” HHS spokesman Nick Papas said.
What this should be is an example that the health insurance companies will not go down without a fight ... and that they will continue to exert every legal strategy to deny coverage ... and I thought the Republicans opposed trial lawyers.
UPDATE : Good news ... despite what Mr. Kline may have thought, Congress can act and the Obama Administration can exert influence :
Education and Labor Committee Chairman, George Miller (D-CA) -- the same committee that Mr. Kline serves wrote a terse letter of objection :
“Under the legislation that Congress passed and the President signed yesterday, plans that include coverage of children cannot deny coverage to a child based upon a pre-existing condition. We have been assured by the Department of Health and Human Services that any possible ambiguity in the underlying bill can be addressed by the Secretary with regulation.
We fully expect that this legislation will prevent insurance companies from denying coverage. The concept that insurance companies would even seek to deny children coverage exemplifies why we fought for this reform effort and will continue fighting to ensure all Americans have access to high quality, affordable care.”
Health and Human Services Secretary Kathleen Sebelius followed up with a letter to Karen Ignagni, president of America’s Health Insurance Plans, a national association representing more than 1,200 health insurance companies.
“Health insurance reform is designed to prevent any child from being denied coverage because he or she has a pre-existing condition. Leaders in Congress have reaffirmed this in recent days in the attached statement. To ensure that there is no ambiguity on this point, I am preparing to issue regulations in the weeks ahead ensuring that the term “pre-existing condition exclusion” applies to both a child’s access to a plan and to his or her benefits once he or she is in the plan. These regulations will further confirm that beginning in September, 2010 :
- Children with pre-existing conditions may not be denied access to their parents’ health insurance plan;
- Insurance companies will no longer be allowed to insure a child, but exclude treatments for that child’s pre-existing condition.
I urge you to share this information with your members and to help ensure they cease any attempt to deny coverage to some of the youngest and most vulnerable Americans.”
Secretary Sebelius concludes :
“Now is not the time to search for non-existent loopholes that preserve a broken system. Instead, we should work together to do the hard work of improving the affordability, quality, and accessibility of our health care system. I look forward to working with you to achieve that goal.”
Ms. Ignagni has responding agreeing to “fully comply” with the new regulations. Ignagni noted that “Health plans recognize the significant hardship that a family faces when they are unable to obtain coverage for a child with a pre-existing condition.”
The Obama Administration is not getting the credit for taking on the tough issues.
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