I mentioned this in The Roundup yesterday, but this move from the insurance industry is predictable, but nonetheless takes some gumption.
Some of the country’s most prominent health insurance companies have decided to stop offering new child-only plans, rather than comply with rules in the new health-care law that will require such plans to start accepting children with preexisting medical conditions after Sept. 23.
The companies will continue to cover children who already have child-only policies. They will also accept children with preexisting conditions in new family policies.
Nonetheless, supporters of the new health-care law complain that the change amounts to an end run around one of the most prized consumer protections.
“We’re just days away from a new era when insurance companies must stop denying coverage to kids just because they are sick, and now some of the biggest changed their minds,” Ethan Rome, executive director of Health Care for America Now, an advocacy group, said in a statement. “[It] is immoral, and to blame their appalling behavior on the new law is patently dishonest.”
WellPoint and CIGNA, two of the insurers who made this decision, are among the biggest in the marketplace. Despite this, child-only plans represent between 100,000 and 700,000 individuals nationwide, so this might not have a huge impact. In addition, poor children with pre-existing conditions would qualify without exclusion under Medicaid or SCHIP.
However, this is not the only area where we’re seeing something like this. The ACA creates a law forcing a high medical loss ratio; insurance companies try to game it (consumer advocates appear to have won the first round, however). The ACA put into place early provisions like limiting annual and lifetime limits and allowing children to stay on their parents’ policies until the age of 26; insurance companies use that as a pretext to jack up premiums, far beyond the cost of these measures. The ACA chopped the donut hole in half in the near term and eventually will eliminate them; pharmaceutical companies may respond by increasing drug prices to offset the cost of the discount.
So in addition to having to fend off the slow chipping away of the law by the GOP, especially if they gain power over one or both houses of Congress, Democrats have to deal with the foxes they left in the henhouse, who are systematically working to preserve their own profits at the expense of consumers. This could have been mitigated by real competition in the marketplace through a public insurance option, or of course removed as a problem with a single-payer system. Neither of those options occurred, and we’re left with a health care system still hampered by a giant profit-sucking machine at its center.
The Obama Administration thinks they can get the insurers to renege on this promise on a technicality:
But officials of the Obama administration said the move contradicted a letter from the leader of one of the insurance industry’s most important trade groups after the law’s adoption in March. Karen Ignagni, president of America’s Health Insurance Plans, expressed support for the law’s provisions concerning children with preexisting conditions and promised to “fully comply” with them.
“We expect [insurance companies] to honor that commitment. Insurers shouldn’t break their promise and turn their backs on some of our most vulnerable Americans,” said Jessica Santillo, a spokeswoman for the Department of Health and Human Services.
Yeah, I’m sure that piece of paper they signed will certainly back them up and change their minds.
It’s almost exciting to see what new and innovative strategies the industry will take with additional rollouts of parts of the law. Exciting in that tragic way.




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I recall hearing some expert early on explaining that the Obama administration didn’t want to be disruptive when it reformed health care. I still don’t know how in the world any intelligent person could take that position. The system is, and has been, broken for a long time. Being disruptive was the only way to have fixed it. What a sorry state of affairs we now have, depending on these for-profits to do the right thing. What a joke!
“Don’t let the immoral be the enemy of corporate profits”…or something.
Seems to me that this is the situation we had before that led us to the current sad state where we have to do something under law to correct the problem. I’m with you in that there is no way to fix a corrupted system that doesn’t disrupt it.
And then there’s this:
Shaking loose $155 million is not a minor feat.
Nonetheless, this is the time to start framing the argument to fix the law (single payer would be obvious to most sentient beings). We have until 2014 to secure single-payer healthcare (Medicare for all) or a national health service (VA for all). That’s the only way we will avoid the shit hitting the fan in 2014. The above news and the folks who can afford it who can now get coverage in spite of pre-existing conditions contribute support to the act and prevent an across-the-board Republican repeal.
@2 – When did morality ever enter into US politics?
Sicko — Plot Synopsis:
Writer/producer Michael Moore interviews Americans who have been denied treatment by our health care insurance companies — companies who sacrifice essential health services in order to maximize profits.
Time for Sicko II?
Not surprising.
Expected, actually.
I haven’t posted in awhile (too busy at work) but wanted to let everyone know Pres Obama will be on a live teleconference at 4:00 PM EST re the Affordable Care Act. As the adm of a rural health clinic / nat’l health service corp, I was invited to participate in this conf. If anyone would like to listen in, call:
888-455-6860 or 888-844-9416
Obama plays the U.S. public for naive fools. Fortunately for him many, if not most, are.
You can’t legislate greed Period! The only way to fix the health care issue is a national medical system AKA Single Payer.. Of course BO said there was no consensus.. Are you kidding over 70% of the public want it. The insurance companies have sucked the life out of US citizens..
How fitting. Right after NAFTA sucked out the jobs from American workers.
When corrupt individuals – who wholesale embrace and venerate greed and gluttony as their guiding principles – act out a Kabuki show of “Health Care Reform,” this can be the ONLY result.
Thanks for reporting on this unsurprising development, which just underlines the current communique I got from my BigIns provider stating that my deductibles and plan costs will RISE this year. Thanks for your backroom deals, Obummer; guess your kickback was big enough.
As long as T-baggers can be brainwashed to lash out at attempts to really truly fix this broken system, we will be at the mercy of corruption, greed and gluttony of the corporations and the oligarchs.
I just read a story in the San Francisco Chronicle that made me sick, as most articles about health “reform” tend to do. Just in time for the mid-term elections, some provisions are supposed to start Thursday. Young adults can now stay on their parents’ health care plans until they’re 26 BUT this doesn’t really go into effect until their next insurance plan “policy year.” For many with employer-based coverage, that’s Jan. 1, 2011 or later.
Link
Typical. Thanks for nothing, Obummer, Oligarchs and T-baggers. Good job! That was the ONE provision that really was meaningful for many… and even that’s whittled down. Not unexpected, though.
Obama has earned a primary challenge in 2012.
Blue Texan’s regularly scheduled post is ready: South Carolina Republican: Ronald Reagan Wouldn’t Cut It in Today’s Teabaggy GOP
Everything goes including human suffering and death in the name of money, greed, and profit. That’s the American way.
CIGNA in NC just raised my individual, employer-based premium by 53% – for a useless plan that doesn’t even cover prescription drugs. I’ve paid into CIGNA for nine years and have never been sick. The new policy will cost $1,360/mo. The explanation is that they are getting a leg-up before the health insurance reform measures take effect. Consider, too, that my new ‘Cadillac Plan,’ that covers almost nothing and whose premium is not negotiable, will be taxable.
The next time Obama tries to claim the moral high-ground (and insists I should be grateful for his grand accomplishment) by using a child with a pre-existing condition in his rap, I will consider that he’s moved from being deceptive to outright dishonesty.
Never again.
KILL THE BILL!!! KILL THE BILL!!! KILL THE BILL!!
Oh wait, wrong thread?
What? Kill the most progressive legislation in a generation?
If parents withholds medical care from a sick child and that child dies as a result of their criminal negligence, the parents are held responsible, arested, and tried for murder.
On the other hand:
If the entire apparatus of the government, in colusion with the health care, medical, and pharamaceutical industries withholds medical/health/drug care from a seriously ill person and that person dies, there are no legal consequences and no one is held accountable, punished, or imprisoned. In fact our predatory capitalistic system encourages and rewards the whole health care conglomerate for murdering our fellow citizens: the more medical care the corporations withhold, the greater the profits of the corporations, the more valuable their stock becomes, more, savvy investors will acquire their stock, and thus this criminal cycle will perpetuate itself ad nauseam.
What possible conclusion can be drawn from this example: We the proud, the brave, and the free willingly allow ourselves with almost no protest to be murdered.
Of course in civilized western social democracies such practises have been outlawed for a very long time.
The true law of the land in the United States is that profits must be protected at all costs, and will always take precedent over the wellbeing of the people.
Perhaps one day the people will decide they have had enough and figure out that voting is not the answer.
Why?
Great update David, thanks.
Great comments too . . . Nahant, I’d say more like 80% would take single payer if the right question was asked. ;-)
Bluetoe, spot on every word.
Easily foreseeable. Perfectly logical and predictable behavior on the part of the insurance companies. Made all the worse by a mandate to purchase their product. It was always wishful thinking to think that a business would not act in its own best interests. The insurance companies didn’t violate the terms of their promise. This is exactly why competition was so important and such a big failure to not include. This is just as big a potential fiasco as Iraq where potential problems were pointed out beforehand, ignored, belittled, occurred and then claimed to not have been foreseeable.
In what rainbows and unicorns, It’s-A-Small-World fairly tale land will the nominal “Democrats” have larger majorities than they had to do it right in 2009? The moment is gone, for a long time. Obama pissed it away with his shady backroom deals.
Promises don’t mean jack, legally. Commitments, statements of intent, whatever — none of it is enforceable.
Why the hell didn’t our political leaders put mandatory laws and regulations into the health insurance ‘reform’ (sic) bill?
Oh right — because the corporations wrote it.
And one further point….this “we have until [blank] to pass [blank]” can kiss my ass. “Make me do it”. Horseshit. Progressives did everything under the sun to make them pass an extremely watered down public option, calls, letters, whipping Congress, and were constantly told to shut up and don’t sink this P.O.S. bill. We knew it would be a disaster and no one wanted to listen to us.
Obama ran on a platform of the public option and drug re importation , and received record support to do just that. This collective guilt BS can walk.
It’s likely to not be the same group of Democrats and Republicans after 2012. And if folks who advocate doing third parties actually succeed in doing it, Bernie Sanders might not be so lonely.
This stopping of child only policies was expected.
There is no upside to offer these and no sharing of the claims procedure so the company is not massively hurt by massive claims from children with extreme problems.
HCR could be made to work using insurance companies -but it requires massive regulation and the gov telling the companies how do their business – treat them like utilities – indeed use the German semi-annual rate control tight regulation system.
If we can’t do that we must go single payer with a national budget for basic services – with regulation to force provider prices for basic services to require approval of the state.
I’m sorry that a proposed strategy for the future looks like collective guilt. The only shame belongs to the Democrats in Congress and their staffs who listened to Politico more than to their constituents.
The issue doesn’t go away and the 2014 clock sits out there ticking.
There is no “we” in this. There is a “they”. And “they” aren’t going to pass it.
As Norman Mailer put it, “this lurching, unhappy, pompous and most corrupt nation” looks like it is pretty much through with the facade of helping the majority of its citizens.
Obama traded away the public option in June to the “for profit” hospital industry, yet gave several speeches well into the fall claiming his support for it.
IMHO that is outright dishonesty.
BTW the insurance industry wrote the bill, not to surprising they already had the loopholes mapped out.
We basically we traded the mandate for nothing.
But most people here already saw that a year ago.
Absolutely right. Doesn’t matter which D’s and R’s are in the congress. As is noted-rightly-of the teabaggers, once in office they will take their marching orders from the center. Or else.