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View Diary: Go Sebelius! UnitedHealth to stop dropping policies of sick! (58 comments)

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  •  I don't quite get that (1+ / 0-)
    Recommended by:
    Clarknt67

    By the time such a thing got set up, it would probably be just about time for the law to take effect, which mandates a review.

    •  Yeah. (1+ / 0-)
      Recommended by:
      jpmassar

      Join Our Countdown To Health Reform! Project I work with Progressive Congress Action Fund, a 501(c)4.

      by slinkerwink on Wed Apr 28, 2010 at 12:10:45 PM PDT

      [ Parent ]

      •  this obviates the panel reviews entirely (0+ / 0-)

        no rescissions, no need for panel review.

        People are upset Obama hasn't solved all the problems yet. C'mon, he's only been in office one year...the man went to Harvard, not Hogwarts. - Wanda Sykes

        by Cedwyn on Wed Apr 28, 2010 at 12:15:30 PM PDT

        [ Parent ]

        •  Not true. There still will be recissions (1+ / 0-)
          Recommended by:
          pamelabrown

          otherwise they wouldn't be setting up panel reviews.

          Join Our Countdown To Health Reform! Project I work with Progressive Congress Action Fund, a 501(c)4.

          by slinkerwink on Wed Apr 28, 2010 at 12:16:38 PM PDT

          [ Parent ]

          •  you just said you don't know that they are (1+ / 0-)
            Recommended by:
            snackdoodle

            and if they're all agreeing pre-emptively to quit rescinding policies before doing so becomes a crime, there's no need for panel review.

            People are upset Obama hasn't solved all the problems yet. C'mon, he's only been in office one year...the man went to Harvard, not Hogwarts. - Wanda Sykes

            by Cedwyn on Wed Apr 28, 2010 at 12:31:30 PM PDT

            [ Parent ]

            •  You clearly haven't read my comments (0+ / 0-)

              below checking on that.

              http://www.dailykos.com/...

              Join Our Countdown To Health Reform! Project I work with Progressive Congress Action Fund, a 501(c)4.

              by slinkerwink on Wed Apr 28, 2010 at 12:33:26 PM PDT

              [ Parent ]

              •  and you clearly didn't read this diary (3+ / 0-)
                Recommended by:
                vc2, QES, clubbing guy

                your comment:

                   Democrats, in letters to seven insurers on Tuesday, said the companies should implement the rescission ban immediately and institute independent, third-party reviews of any decisions to drop coverage.

                   UnitedHealth "is aggressively seeking outside vendors and will be instituting independent, external third party review in the near term," the company said.

                   Aetna and Assurant Health have said they have third-party review systems in place.

                I'm checking out the third-party review system by Aetna.

                this diary:

                Now comes word that United Health will immediately stop terminating healthcare coverage for policyholders after they become ill

                People are upset Obama hasn't solved all the problems yet. C'mon, he's only been in office one year...the man went to Harvard, not Hogwarts. - Wanda Sykes

                by Cedwyn on Wed Apr 28, 2010 at 12:52:30 PM PDT

                [ Parent ]

                •  I was checking out Aetna since (0+ / 0-)

                  they mentioned they have a third-party review system in place. And you again have misread my comment, Cedwyn, as usual.

                  Join Our Countdown To Health Reform! Project I work with Progressive Congress Action Fund, a 501(c)4.

                  by slinkerwink on Wed Apr 28, 2010 at 01:02:51 PM PDT

                  [ Parent ]

                  •  from your comment (0+ / 0-)

                    UnitedHealth "is aggressively seeking outside vendors and will be instituting independent, external third party review in the near term," the company said.

                    which you cited in my reply to my comment above:

                    you just said you don't know that they are [establishing panel reviews]

                    and if they're all agreeing pre-emptively to quit rescinding policies before doing so becomes a crime, there's no need for panel review.

                    the parent comments of which ultimately trace to here:

                    I haven't heard anything about whether they've agreed to do a third party panel review of rescissions as was requested in the letter by Democrats.

                    so, what did i misread, exactly?

                    People are upset Obama hasn't solved all the problems yet. C'mon, he's only been in office one year...the man went to Harvard, not Hogwarts. - Wanda Sykes

                    by Cedwyn on Wed Apr 28, 2010 at 05:16:07 PM PDT

                    [ Parent ]

                    •  You misread that my second comment (0+ / 0-)

                      in this thread was a correction to my first comment. That's what you have misread, cedwyn, as USUAL.

                      Join Our Countdown To Health Reform! Project I work with Progressive Congress Action Fund, a 501(c)4.

                      by slinkerwink on Thu Apr 29, 2010 at 09:02:49 AM PDT

                      [ Parent ]

                      •  i misread nothing (0+ / 0-)

                        Not true. There still will be recissions otherwise they wouldn't be setting up panel reviews.

                        by slinkerwink on Wed Apr 28, 2010 at 12:16:38 PM PDT

                        [ Parent | Reply to This ]

                           
                             

                        you just said you don't know that they are and if they're all agreeing pre-emptively to quit rescinding policies before doing so becomes a crime, there's no need for panel review.

                                  by Cedwyn on Wed Apr 28, 2010 at 12:31:30 PM PDT

                             [ Parent | Reply to This ]

                                 
                                   

                        You clearly haven't read my comments

                                            by slinkerwink on Wed Apr 28, 2010 at 12:33:26 PM PDT

                        that was your second comment.  i did not take it as any correction of something you said, but you implied that it somehow rebutted my point that without rescission, there's no need for panel review.  

                        People are upset Obama hasn't solved all the problems yet. C'mon, he's only been in office one year...the man went to Harvard, not Hogwarts. - Wanda Sykes

                        by Cedwyn on Fri Apr 30, 2010 at 10:38:48 AM PDT

                        [ Parent ]

                        •  Yes, you did misread what I said. (0+ / 0-)

                          Join Our Countdown To Health Reform! Project I work with Progressive Congress Action Fund, a 501(c)4.

                          by slinkerwink on Fri Apr 30, 2010 at 05:30:27 PM PDT

                          [ Parent ]

                          •  and yet (0+ / 0-)

                            you can't explain how exactly.

                            People are upset Obama hasn't solved all the problems yet. C'mon, he's only been in office one year...the man went to Harvard, not Hogwarts. - Wanda Sykes

                            by Cedwyn on Sat May 01, 2010 at 07:16:30 AM PDT

                            [ Parent ]

                          •  I already explained it to you. It's you (0+ / 0-)

                            who refuses to understand.

                            Join Our Countdown To Health Reform! Project I work with Progressive Congress Action Fund, a 501(c)4.

                            by slinkerwink on Sat May 01, 2010 at 07:24:53 AM PDT

                            [ Parent ]

                          •  no; you didn't explain (0+ / 0-)

                            you assumed that i took one of your comments a certain way, but i did not.  i didn't think that comment spoke to anything except my comment it was replying to.

                            let's try this:  how about you explain why panel review is necessary if there is no rescission?  the only thing for them to investigate is actual fraud, since that is a valid reason to drop people.  are you including non-renewals?  cuz that goes away in 3.5 years, too.  

                            don't forget that there is an agency set up in the bill to monitor what insurance cos do twixt now and then.  and you can bet they'll watch for who keeps kicking folks to the curb at renewal times.

                            People are upset Obama hasn't solved all the problems yet. C'mon, he's only been in office one year...the man went to Harvard, not Hogwarts. - Wanda Sykes

                            by Cedwyn on Sat May 01, 2010 at 11:58:53 AM PDT

                            [ Parent ]

                          •  As I and others have pointed out to you (0+ / 0-)

                            there still will be rescissions going on. They'll rescind the policy, allow the policyholder to appeal the rescission to the panel review, where the reviewers will decide if the rescission was valid.

                            It's how Aetna currently handles its rescissions with their third-party 'independent' reviewers.

                            Join Our Countdown To Health Reform! Project I work with Progressive Congress Action Fund, a 501(c)4.

                            by slinkerwink on Sat May 01, 2010 at 04:38:48 PM PDT

                            [ Parent ]

                          •  but that's the whole point of this diary (0+ / 0-)

                            is that those entities agreed to end the practice of rescission.  so what do you mean they will still go on?

                            they said they're not going to drop people for incurring claims anymore.  that leaves only fraud as a reason to drop.  or they can just wait until the policy is up for renewal to drop them, which isn't rescission and will also be illegal when the full HCR bill kicks in.    

                            and the fact that Aetna currently has panel review is irrelevant here.

                            People are upset Obama hasn't solved all the problems yet. C'mon, he's only been in office one year...the man went to Harvard, not Hogwarts. - Wanda Sykes

                            by Cedwyn on Sun May 02, 2010 at 07:22:14 AM PDT

                            [ Parent ]

                          •  Ceddwyn, stop playing dumb here. (0+ / 0-)

                            It should be very clear from what I, others, and this diarist have told you---rescissions will still go on.

                            Join Our Countdown To Health Reform! Project I work with Progressive Congress Action Fund, a 501(c)4.

                            by slinkerwink on Mon May 03, 2010 at 12:22:20 PM PDT

                            [ Parent ]

                          •  and yet (0+ / 0-)

                            that's all you can explain about it.  yannow, slink, someone with the goods to back it up would have done so just to put an end to this.  but all you can do is insist they'll still go on.  you won't even answer direct questions...not exactly the hallmark of someone in command of the facts.

                            People are upset Obama hasn't solved all the problems yet. C'mon, he's only been in office one year...the man went to Harvard, not Hogwarts. - Wanda Sykes

                            by Cedwyn on Tue May 04, 2010 at 06:11:04 AM PDT

                            [ Parent ]

                          •  I did answer your questions, and (2+ / 0-)
                            Recommended by:
                            TomP, ErinW43

                            provided links. You ignored my answers.

                            Join Our Countdown To Health Reform! Project I work with Progressive Congress Action Fund, a 501(c)4.

                            by slinkerwink on Wed May 05, 2010 at 12:22:19 PM PDT

                            [ Parent ]

            •  They're not quitting rescinding policies (0+ / 0-)

              As long as the law states that rescissions can be made if there's fraud or material misrepresentation, they'll do it.

              They're just saying they'll stop rescinding policies unless there's fraud or material misrepresentation, which actually was the existing law before the passage of this health bill.

              And if there is a policy they think is fraud or has material misrepresentation, they'll allow it to be appealed to a third party review panel.

              Join Our Countdown To Health Reform! Project I work with Progressive Congress Action Fund, a 501(c)4.

              by slinkerwink on Wed Apr 28, 2010 at 12:35:35 PM PDT

              [ Parent ]

              •  Source? (1+ / 0-)
                Recommended by:
                slinkerwink

                They're just saying they'll stop rescinding policies unless there's fraud or material misrepresentation, which actually was the existing law before the passage of this health bill.

                I know varying State Laws--California specifically had one--regarding rescission policies... but what federal law prior to the one we just passed made rescission illegal before the passage of PPACA?

                You're saying that PPACA literally changes nothing vis-a-vis rescission law?

                •  I refer you to this (1+ / 0-)
                  Recommended by:
                  TooFolkGR

                  The problem, however, is that the new law still allows what WellPoint has argued it did in these cases--rescind policies because of "fraud or intentional misrepresentation of material fact," as Sebelius points out in her letter. Sebelius should be taking this story very seriously, and recognize the potential still existing under the new law for a broad interpretation on the part of insurers for "fraud and intentional misrepresentation." This is an area HHS needs to pay particular attention to in crafting the regulations for the law to find any possible way in which they can tighten up potential loopholes and make the law enforcable as it was intended.

                  http://www.dailykos.com/...

                  And this is the kind of stuff that will still go on:

                  http://www.lifehealthdisabilityinsur...

                  That's not really a ban on rescissions. "Fraud and intentional misrepresentation of material fact" are precisely the excuses that the insurance companies are using when rescinding policies. Does the Senate actually believe that the insurance companies are telling people that their policy is rescinded because the got sick? No way.

                  They always claim that it's due to fraud or misrepresentations. For example, one of the many horror stories involves a woman's policy being rescinded because she didn't report a prior case of acne. Her insurance company interpreted this as fraud and rescinded the policy. Fraud! The ban on rescissions is supposed to prevent this.

                  http://www.bobcesca.com/...

                  A federal law passed in 1996 bans rescission except in cases of fraud. But the law goes unenforced because there's no regulation at the federal level and nearly all states have much weaker laws on rescission, says Pollitz.

                  http://blog.newsweek.com/...

                  That would be HIPAA.

                  The Health Insurance Portability and Accountability Act (HIPAA) of 1996 (P.L.104-191)

                  Join Our Countdown To Health Reform! Project I work with Progressive Congress Action Fund, a 501(c)4.

                  by slinkerwink on Wed Apr 28, 2010 at 01:58:57 PM PDT

                  [ Parent ]

          •  Agree. (2+ / 0-)
            Recommended by:
            slinkerwink, jpmassar

            There will still be recessions AND rehepensible rate hikes.  I just received a rate hike from BCBS-FL when as an independent member I basically receive a mammogram and a pap smear for years of paying thousands into the system.

            I, for one am glad that Sebelius, for all her blandness, was a strong insurance commissioner .  She knows all the industry's tricks.  If we hold her feet to the fire and organize to close the loop holes, then we stand half a chance to improve the bill.

        •  It's true that if there were NO recissions (1+ / 0-)
          Recommended by:
          slinkerwink

          there would be no need for panels (for this particular issue).

          But it seems likely that the statement is not 100% accurate.  The insurance companies will still want to resciss policies they feel were entered into fraudulently, for some hopefully much narrower standard of fraudulently, but nonetheless still possible (e.g., someone who is dead gets a policy, and someone who is not impersonates that person).

          So it would still be good if there were an independent evaluation of the fraud claim, rather than leaving it to the insurance company to decide, and then having the person have to sue in court.

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