Health and Human Services Secretary Kathleen Sebelius has shut down the latest effort by insurers to limit coverage to children.
WASHINGTON — Health insurers can't have different rules for selling individual policies for children with medical problems and for healthy children, the Department of Health and Human Services said Wednesday.
Some insurers want to allow healthy children to enroll year-round but only have a limited enrollment window for those with pre-existing conditions. Not so fast, HHS Secretary Kathleen Sebelius said in a letter to the National Association of Insurance Commissioners.
Such an approach is legally questionable and "inconsistent with the language and intent" of the health care law, Sebelius wrote....
Parents of sick children may still find other challenges, however, including the availability and cost of the coverage. Some states place no limits on how much could be charged for that coverage.
Insurers reacted to the letter, claiming that HHS "has created a powerful incentive for parents to defer purchasing coverage until after their children need it — which could significantly raise costs and cause disruptions for families whose children are currently covered by child-only policies," said Robert Zirkelbach, a spokesman for America's Health Insurance Plans, a trade group representing insurers.
Some insurers, worried about an influx of sick children who'd be expensive to cover, have dropped out of the child-only individual market entirely.
Insurers are going to try to exploit every loophole they can possible find, and even to poke new ones into the fabric of the Affordable Care Act if one doesn't already exist, as is evidenced by this attempt to shut down the enrollment window for sick kids. Health insurance reform is still a work in progress, with HHS and the states having to remain vigilant in regulating insurers. And this is just with the initial reforms kicking in--they're probably going to fight even harder against the 2014 reforms. That is if they haven't bought a new Congress and President by 2014 to overturn reform.