Pre-existing condition coverage in jeopardy
March 29th, 2010Robert Pear, writing in the New York Times, says architects of the new health care law had intended that the measure ban discrimination against children with certain pre-existing conditions like asthma, diabetes, birth defects, orthopedic issues, leukemia, cystic fibrosis and sickle cell disease, requiring that insurance coverage be extended to them.
But days after the bill’s signing, he says, insurance companies are already arguing that they do not have to provide such coverage, at least for now. Congressional Democrats reacted angrily to statements by insurers. An excerpt:
Insurers agree that if they provide insurance for a child, they must cover pre-existing conditions. But, they say, the law does not require them to write insurance for the child and it does not guarantee the “availability of coverage” for all until 2014.
William G. Schiffbauer, a lawyer whose clients include employers and insurance companies, said: “The fine print differs from the larger political message. If a company sells insurance, it will have to cover pre-existing conditions for children covered by the policy. But it does not have to sell to somebody with a pre-existing condition. And the insurer could increase premiums to cover the additional cost.”
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April 2nd, 2010 at 2:33 am
In the country I live in (not a socialist country) a law was enacted several years ago which obliges 100% of the population to have private health insurance. At the same time, it was made illegal for private health insurance providers to refuse coverage for basic medical needs (physicians’ bills, pharmacy, physiotherapy, public hospitalization in wards, etc.) to people with pre-existing conditions (though there is still exclusion for complementary insurance policies, e.g. hospitalization in private clinics).
Though our insurance premiums continually go up (and aren’t cheap by any stretch of the imagination), universal coverage has meant that nobody goes broke trying to pay medical bills in cases of catastrophic illness.
The problems with health care coverage in the U.S. was brought home to me by an American graduate student I hired 2 years ago to work part-time for my employer. She is 25, was obliged to have health insurance here, had had no health insurance in the States. She was diagnosed last summer with metastased renal cell carcinoma with tumors in her brain and lungs. She has undergone 5 major surgeries (including 2 brain surgeries) and extremely expensive pharmaceutical therapy and repeated whole brain radiations. Given the excellent level of care, she has survived longer than the usual prognosis, but she is an exile here. She cannot go home. Her family cannot afford to pay for her care. Her care over the past year has certainly exceeded $300,000 so far.
I read about the “high-risk pool” for people with pre-existing conditions (and without prior insurance coverage) that is supposedly coming into effect within 90 days and cover patients until the rule on not excluding pre-existing conditions comes into play in 2014.
Won’t this “high-risk pool” eliminate the above-mentioned loophole and let this girl go home?