That didn't take long. Something like 72 hours before health insurers say that no, they really don't have cover kids with pre-existing conditions, as nyceve nicely chronicles. Here's what AHIP says:
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.
Health insurers worry that if they're forced to cover all children regardless of health condition, higher rates will result, because only the families of sick kids would apply. That problem, they say, could be largely avoided if the requirement went into effect in 2014, when most Americans will have to have coverage under the law. AHIP says higher rates resulted when New York and a handful of other states enacted "guarantee-issue" laws requiring insurers to offer coverage to all applicants.
"Higher rates resulted," not "insurers seeking to maintain a healthy profit margin raised rates." As if insurers had no control over premiums. The administration and congressional Dems obviously disagree with AHIP's assement.
Responding to the concerns, Obama administration officials said Wednesday the law does prohibit insurers from denying children coverage starting this year, but they will issue clarifying regulations. "The law is clear: Insurance plans that cover children cannot deny coverage to a child because he or she has a pre-existing condition," Health and Human Services spokesman Nick Papas said. "To ensure that there is no ambiguity on this point, the Secretary of HHS is preparing to issue regulations next month making it clear that the term “pre-existing exclusion” applies to both a child's access to a plan and to his or her benefits once he or she is in the plan.”
Reps. Henry A. Waxman, Sander M. Levin, and George Miller, the Democratic chairmen of the three committees with jurisdiction over health policy in the House of Representatives, said Wednesday that the administration response should be sufficient.
“Under the legislation ... plans that include coverage of children cannot deny coverage to a child based upon a pre-existing condition," the joint statement said. "We have been assured by the Department of Health and Human Services that any possible ambiguity in the underlying bill can be addressed by the Secretary with regulation."
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.
There's no reason for Congress or the administration to rely upon regulations to clarify this. Pass a new stand-alone bill. Fast-track it. See who in Congress is willing to stand with insurers and deny coverage to sick children. That'll be a fun vote. And should sail through.
Or, the House could take that intransigence from AHIP seriously, and as a an indication as things to come from the insurance industry (because we all know that if they're willing to keep sick kids out, they'll figure out a way to avoid most of the other restrictions in the bill) and attach a public option when they vote on the returned reconciliation package. An unlikely occurrence, I admit, but just about the only thing that could get insurers to shape up.
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