Round Two in the Fight to Cover Children with Pre-Existing Conditions: Cost.
April 2nd, 2010
By Santi Bhagat, MD, MPH. Health Care Reform is off to a good start. A couple of days ago, I blogged on the debate between the insurance industry and the administration about the interpretation of this new law. Hats off to insurers for making the right choice, right away, to heed regulations that are forthcoming from Health and Human Services. I first heard this through the grapevine at the Disruptive Women Breakfast Series this week from Stephanie Cohen, the expert panelist representing the insurance industry.
The law is intended to require insurers to issue policies that provide a full range of benefits for all children with pre-existing conditions starting in September 2010. That means insurers can no longer refuse to cover children with pre-existing conditions under their parents’ plans, even if the children never had insurance.
This law has far-reaching ramifications. A recent story about a newborn who was denied coverage at the age of a mere 9 days highlights how critical this law is. Born with a congenital heart defect, Houston Tracy underwent lifesaving open heart surgery when he was just 4 days old. His parents cannot afford insurance for themselves, being small business owners, and have individual policies for their older two sons. After being charged and given the run-around by the insurance company, they resorted to enrolling their newborn in the state’s high-risk pool.
The big question now is how much will insurers charge for these policies. If the price tag is too high, parents will not be able to afford to purchase policies, and in effect, coverage will be denied to these children.
It is not clear whether HHS regulations will speak to this issue. The administration will be watching the insurance industry closely. So will we.
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