Anybody with children in Grand Prairie, Arlington, Mansfield, Fort Worth, Dallas, or out in Weatherford would want to know how the new federal health bill is being interpreted by lawyers and insurance companies. This was the topic of a recent article in The New York Times.
The article is titled “Coverage Now for Sick Children? Check Fine Print.” This article was published on March 28, 2010. This was right after the new federal health care law was signed into law by President Obama.
One selling point for the new law was that pre-existing conditions coverage for children would immediately go into effect. The reality is that it probably does not. The health insurance companies agree that they must cover pre-existing conditions for children already covered by a policy of insurance. That has consistently been the case. But, the health insurers argue that the new law does not require them to write new insurance for a child and it does not guarantee the “availability of coverage” for all until 2014.
The insurance company attorneys insist that the fine print in the law differs substantially from the larger political message. The companies are required to cover pre-exisiting conditions for children if a policy is sold but they are not required to sell a policy. Plus, the health insurance company could increase premiums to cover the additional cost.
As stated in the article, Senator John D. Rockefeller IV, Democrat of West Virginia and chairman of the Senate commerce committee, said: “The ink has not dried on the health care reform bill, and already some deplorable health insurance companies are trying to duck away from covering children with pre-existing conditions. This is outrageous.”
Karen L. Pollitz, a research professor at the Health Policy Institute at Georgetown University, is quoted as saying, “If you have a sick kid, the individual insurance market will continue to be a scary place.”
National Association of Insurance Commissioners experts, share this concern.
What happened in the past and what will probably continue to happen until 2014, when the law mandates coverage, is that a health insurance company will simply deny coverage not only for the child but the entire family, instead of refusing to cover treatment for a specific pre-existing condition.
White House spokespeople say the administration planned to issue regulations setting forth its view that “the term pre-existing applies to both a child’s access to a plan and his or her benefits once he or she is in a plan.” Lawyers agree the rules could be challenged in court if they went beyond the law or were inconsistent with it.
The New York Times article is a good read for pointing out a few other inconsistencies betweent the politicing and what the actual bill says.
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