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Tag Archives: pass the bill to find out what’s in it

Pre-Existing Condition Loophole?

26 Friday Mar 2010

Posted by Craig in Congress, health care, lobbyists, Politics

≈ 3 Comments

Tags

America's Health Insurance Plans, Baucus, Blue Cross Blue Shield, health care reform, Kaiser, Liz Fowler, lobbyists, pass the bill to find out what's in it, pre-existing conditions, Senate Finance Committee, Speaker Pelosi, WellPoint

When Speaker Pelosi said of health care reform legislation on March 9 that “we have to pass the bill so that you can find out what is in it, away from the fog of the controversy,” I would guess she was referring to all the positive elements of the bill which would come to light after all the sturm und drang of the debate had passed. However, there appears to be some controversy only 2 days after the bill’s passage over the ban on denying coverage based on pre-existing conditions. From AP via Firedoglake:

“President Barack Obama’s new health care law has a gap when it comes to one of its much-touted immediate benefits, improved coverage for children in poor health, congressional officials confirmed Tuesday.

Under the new law, insurance companies still would be able to refuse new coverage to children because of a pre-existing medical problem, said Karen Lightfoot, spokeswoman for the House Energy and Commerce Committee, one of the main congressional panels that wrote the bill that Obama signed into law Tuesday.”

According to Kaiser, the language in the legislation is a bit murky (intentionally perhaps?) :

“…health advocates and some insurers say the law does not clearly state that such protection starts this year. If it doesn’t, uninsured children with pre-existing conditions might not get help until 2014, when the law requires  insurers to issue policies for all applicants regardless of health condition.

…One thing is clear: The law does nothing to stop insurers from charging higher rates for children with pre-existing illnesses until 2014 when insurers can no longer use health status in setting premiums.”

Of course the insurance companies and their lobbyists jumped all over this possible loophole:

“Randy Kammer, a vice president for Blue Cross and Blue Shield of Florida, the largest health insurer in that state, said she interprets the law as allowing insurers to reject coverage for children in some cases until 2014.

America’s Health Insurance Plans, the main insurance lobbying group, says through a spokesman that it interprets the new law as not requiring insurers to cover all child applicants this year.”

It’s almost as if the insurance companies knew the loophole was there. Couldn’t have anything to do with Liz Fowler, a former VP of WellPoint, being a senior aide to Sen. Baucus and director of the Senate Finance Committee health care staff, could it?

The response from the administration is that “clarifying regulations” will be forthcoming from the Department of Health and Human Services. “Clarifying regulations” for 2-day old legislation? The old carpenter’s adage about ‘measure twice, cut once’ comes to mind.

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