| Denying Coverage To Those With Pre-Existing Conditions Subject Of New Federal Report
Just in time to add fuel to the health insurance reform
debate, the federal Department of Health and Human Services (HHS) has
shone a spotlight on the industry’s practices of denying coverage
to individuals with pre-existing conditions.
The report, "Coverage Denied: How the Current Health
Insurance System Leaves Millions Behind,"scrutinizes health insurance
company practices of denying coverage to or discriminating against
Americans who have pre-existing medical conditions.
HHS noted that a recent national survey found that 12.6
million non-elderly adults – 36 percent of those who tried to buy
insurance on the private market – were discriminated against in
the past three years because an insurance company deemed them
ineligible for coverage because of a pre-existing condition, charged
them a higher premium, or refused to cover their condition.
"Another survey found 1 in 10 people with cancer said
they could not get health coverage, and 6 percent said they lost their
coverage because of their diagnosis," HHS said.
The insurance company practice of denying coverage
because of pre-existing conditions is not confined to serious diseases,
the report noted. "Even minor problems such as hay fever could trigger
prohibitive responses."
"In 45 states insurance companies can discriminate
against people based on their pre-existing conditions when they try to
purchase health insurance directly from insurance companies in the
individual insurance market. Insurers can deny them coverage, charge
higher premiums, and/or refuse to cover that particular medical
condition," said the report.
An insurer could charge high premiums, deny coverage, or
set a restriction such as denying any respiratory disease coverage to a
person with hay fever, according to the report.
Some insurance companies respond to an expensive
condition such as cancer by initiating a thorough review of the
patient’s health insurance application. If the company discovers
that any medical condition, regardless of how minor, was not reported
on the application, it could revoke coverage retroactively for the
patient and possibly all members of the patient’s family, the
report said. The practice is known as rescission.
Companies can do this even if the condition found is not
related to the expensive condition or if the person wasn’t aware
of the condition at the time, the report charged.
"At least one company encouraged employees to revoke sick people’s health coverage through rescissions," the report said.
"When a person is diagnosed with an expensive condition
such as cancer, some insurance companies review his/her initial health
status questionnaire. In most states’ individual insurance
market, insurance companies can retroactively cancel the entire policy
if any condition was missed – even if the medical condition is
unrelated, and even if the person was not aware of the condition at the
time," the report said. "Coverage can also be revoked for all members
of a family, even if only one family member failed to disclose a
medical condition."
Under terms of the proposed health insurance reform
currently being debated in Washington, insurance companies would be
prohibited from refusing coverage based on someone’s medical
history or health risk. "Companies also would be barred from watering
down coverage or refusing renewal because someone becomes sick," the
report noted. Companies would have to renew any policy as long as the
policyholder pays the premium in full.
The report is available at www.HealthReform.gov.
|
Health Plan CEO Representative Compensation
|
|
2007 CEOs
|
2007 Total Compensation
|
2008 Total Compensation
|
Increase/Decrease
|
Percent Change
|
|
Aetna –
Ronald A. Williams
|
$23,045,834
|
$24,300,112
|
+$1,254,278
|
+5.4 percent
|
|
CIGNA –
H. Edward Hanway:
|
$25,839,777
|
$12,236,740
|
-$13,603,037
|
-52.6 percent
|
|
Coventry –
Dale B. Wolf
|
$14,869,823
|
$9,047,469
|
-$5,822,354
|
-52.6 percent
|
|
Health Net –
Jay M. Gellert
|
$3,686,230
|
$4,425,355
|
+$739,125
|
+20.1 percent
|
|
Humana –
Michael McCallister
|
$10,312,557
|
$4,764,309
|
-$5,548,248
|
-53.8 percent
|
|
U. Health Group –
Stephen J. Hemsley
|
$13,164,529
|
$3,241,042
|
-$9,923,487
|
-75.4 percent
|
|
WellPoint –
Angela Braly
|
$9,094,271
|
$9,844,212
|
+$749,941
|
+8.2 percent
|
Source: Health Reform Watch
|
