...only, unfortunately, no one is following him. This really ought to be high on the Progressive agenda because of the number of people this issue impacts.
Employee Retirement Income Security Act of 1974 (ERISA)
Americans don't tend to know how ERISA impacts them until they befall some situation which requires substantial use of the insurance benefits from their employer for health or disability.
It's only after things go very, very wrong with delivery of that benefit that they discover that U.S. law protects insurance companies over the citizens whom the law was written to protect. By definition, the people who are caught in this ERISA net are those who are sick and disabled and least able to fight for their rights. I only know about ERISA from having slammed into it myself - me and those in a similar boat make the crowd insurance companies would like to 'die quickly,' as has been recently noted.
According to Representative Shadegg, the health care bill currently 'preserves and extends' ERISA Section 514.
The following testimony took place on July 31, 2009, but it did not get the attention it needed then, and it is about a section of the health care reform bill which has not yet had light shed on it.
Link to video in case it's needed.
Following is the transcript of the first minute or so of the tape - if you can watch the whole thing, the story told in it is quite powerful:
This amendment is to a stealth provision of the bill, it's a provision to the bill that no one has talked about in the press, and no one has talked about in this room. It's a provision I'm betting that no one here really knows is in the bill, or what it does. Under current law, if an ERISA governed plan (that means a Union plan or an employer plan) negligently - or even willfully and in bad faith - denies coverage to an employee, and that employee is either injured or killed by the denial of coverage, that employee can recover NOTHING for their injuries. Nothing, even if there is a wrongful death.
Now one would think that that's the kind of injustice that Congress would want to correct. No one in America should be left to suffer a loss like that, from the wrongful denial of coverage, and recover nothing. But this bill, not only doesn't fix this problem, it literally preserves and extends it.
--Representative John Shadegg
There were ZERO co-sponsors on either side of the aisle for Shadegg's amendment in the House, and no one has proposed anything similar on the Senate side - Shadegg's office was hoping Senator Kennedy might work with them, as he was interested...
Here's the short story: Because of ERISA Section 514, an insurance company can deny a person coverage and there's pretty much no recourse. If it's health care denied, as the dKos community well knows, sometimes people die. The insurance companies will thank you for choosing them and allowing them to investigate your concerns, then they'll tell you to take them to court.
Under ERISA provisions, all you can win in court is the service you were previously entitled to but didn't get or what you were already owed monetarily. Damages and attorney's fees are not allowed, nothing to give a company any incentive to reconsider these practices.
In other words, the insurance companies have a business incentive to throw people off of their rolls if they think they can get away with it because the vast majority of those tossed will never end up figuring out how to sue, and heck, even if someone did sue and win, well, the insurance company is only out what they would have paid to begin with. It's a very neat little system.
As Shadegg concludes, doctors can be liable for their errors and omissions and yet insurance companies are immune from being held accountable for their denials. It's a neat little system they got going.
Representative Shadegg has apparently been working on this issue for a decade. I didn't expect to be phoning a Republican to thank him for supporting my rights, but I sure did today.
More information about the Corcoran case mentioned by Shadegg and how ERISA can tie the hands of those in need.