Using some of the strongest language I’ve ever seen from this group, Health Care for America Now basically charged WellPoint with murder today, responding to the Murray Waas article showing that the insurance giant systematically dropped breast cancer patients from the rolls. HCAN spokesman Avram Goldstein released this statement, intimating that criminal prosecutions should be pursued in this case:
“WellPoint is committing murder by spreadsheet, and it has to stop now. This is a matter of life and death, and the executives and board members of WellPoint need to be held to account to the fullest extent of the law.
“WellPoint’s Blue Cross-Blue Shield companies’ disregard for human life to maximize profits is immoral and outrageous. The Reuters report shows an unconscionable pattern of denying needed health care to line the pockets of wealthy executives and shareholders.
“Today’s disclosure provides more evidence of why Congress needed to pass national health reform in the first place, and it also shows why we need to curb the extraordinary influence of insurance companies so they don’t interfere with enforcement of the new law. We need the forthcoming federal regulations to shine a light on the insurance companies and hold them accountable for their bad practices.”
Actually, what we needed is for groups like HCAN to ensure during the debate that practices like this would truly get outlawed by the Affordable Care Act. In actuality, insurance companies, led by WellPoint, lobbied for changes to the restrictions on their business and a de-fanging of the law. Much like in the current financial reform debate, they ended up leaving a lot of the regulatory authority open-ended and at the discretion of regulators, in this case the Health and Human Services Secretary and the National Association of Insurance Commissioners. Jon Walker laid out how WellPoint successfully removed independent third-party review of all rescission cases.
Reuters reports that WellPoint is under federal investigation for singling out breast cancer patients and dropping their coverage “based on either erroneous or flimsy information.” They also report that language in the House bill would have protected these women, but it was removed in the Senate version of the bill because “lobbyists for WellPoint and other top insurance companies successfully fought proposed provisions of the legislation.”
Max Baucus, head of the Senate Finance Committee, credits former WellPoint VP Liz Fowler with writing the “blueuprint” of the bill, and her name appears as “author” on the bill PDF released by the committee [...]
As you can see, the Senate bill does not mandate either independent third party review or the continuation of coverage while the review is taking place. Theoretically it’s possible for the Secretary of HHS to require a similar independent third party review framework for rescission, but unlike the House bill, the Senate bill which ultimately passed does not require her to do so — something WellPoint actively lobbied for.
The White House might argue that rescission is a thing of the past because the law guarantees issue of health insurance, and with risk adjustment insurers will have an incentive to even pick up sick patients. However, in reality the risk adjustment mechanism is far smaller than the liability of sick patients, and insurers will undoubtedly work hard to avoid as many patients with pre-existing conditions as possible.
We now have a whodunit, where we have to ask who in the Senate pushed to eliminate the toughest regulatory restrictions from insurance companies who obviously have no compunction against systematically denying coverage to breast cancer patients. Obviously Liz Fowler, the former WellPoint VP, is a good place to start. So far, nobody privy to those discussions has been willing to say on the record that Fowler is culpable. But the insurance industry, already hated in the country, has now committed what even cautious groups like HCAN call murder. Covering for the culprit here is tantamount to being an accessory to the crime.