In the ongoing debate over whether insurers should abide by the new law and cover sick kids this year, HHS Secretary Sebelius writes to AHIP president Karen Ignagni [pdf], reiterating the intent of the law.
Unfortunately, recent media accounts indicate that some insurance companies may be seeking to avoid or ignore a provision in the new law that prohibits insurance companies from excluding children with pre-existing conditions from coverage.
Health insurance reform is designed to prevent any child from being denied coverage because he or she has a pre-existing condition. Leaders in Congress have reaffirmed this in recent days in the attached statement. To ensure that there is no ambiguity on this point, I am preparing to issue regulations in the weeks ahead ensuring 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. These regulations will further confirm that beginning in September, 2010:
- Children with pre-existing conditions may not be denied access to their parents' health insurance plan;
- Insurance companies will no longer be allowed to insure a child, but exclude treatments for that child's pre-existing condition.
I urge you to share this information with your members and to help ensure they cease any attempt to deny coverage to some of the youngest and most vulnerable Americans. For too long, parents across the country have struggled as pre-existing conditions have prevented their children from accessing affordable, stable health insurance coverage. Health insurance reform eliminates this tremendous source of worry and helps ensure children have the care they need.
The insurers have threatened to take their beef over potential regulations to the courts "if they went beyond the law or were inconsistent with it." This letter from Sebelius will likely not be the last word in this particular story.
Edited for errors in the original transcription.
Update: Even insurers are subject to bad press. Via jimstaro in comments, they're crying uncle on covering the kids, with the implied threat that it's going to cost us.
AHIP said de-linking the requirement to insure sick children from the law's mandate that everyone buy health-insurance coverage, which goes into effect in 2014, could drive up prices in the meantime. But the group said it would do whatever HHS tells it to do.
AHIP spokesman Robert Zirkelbach said the group was calculating how much it would cost to take all comers under 19 years old, and that it shared "the goal of providing coverage to all children."
