The bill creates the pre-existing conditions: seeks to incre

 

Friday, Mar 20,2009, 1:45:04 PM   Click:

Copyright: The Dominion Post, Morgantown, W.Va.
Source: The Dominion Post in Morgantown (West Virginia)
Wordcount: 814


Mar. 18 - Sen. Jay Rockefeller, DW.Va. and Rep. Joe Courtney, D-Conn., introduced Tuesday a bill that would eliminate pre-existing exclusions in insurance policies.

Called pre-existing law on the protection of patients, the bill will stop insurance companies from denying health insurance coverage for chronic diseases like diabetes and heart disease.

Currently, health insurance companies may specify conditions for discovery of new policyholders.

In a conference call with The Dominion Post, the two legislators said the bill was part of Barack Obama president of the agenda of health care reform.

"Our system is broken," said Rockefeller. For "people who have preexisting conditions ... [insurance companies] will wipe you their list. ... The president is angry."

Courtney said in addition to coverage for chronic illnesses, the bill is a crucial part of economic recovery, that recent job losses by many Americans in May on their own to pay for health insurance.

"This legislation is really about moving along the recovery," he said.


The current bill stems from both lawmakers and previous work. In 2007, the duo presented the pre-existing condition exclusion Patient Protection Act, which sought to restrict the insurers and employers to exclude individuals from coverage because of gaps in the protection of health insurance and portability Accountability Act (HIPAA) of 1996, according to Rockefeller website.

Rockefeller said the new bill would increase the effort in the heart of health care reform.

"HIPAA has been thought to be an excellent step forward ... but there were many gaps," he said. "What this bill would do is say everyone gets. There would be no exclusion throughout the country."

Both lawmakers said the change should not hurt the insurance industry, but increase the pot of customers, bringing the cost of premiums.

"I am convinced that this is something that the market may lead," said Courtney. "This will expand the market, increasing the customer base."

But according to David Mathieu, Vice President of Marketing for the Health Plan of Upper Ohio Valley - West Virginia Insurance Company health - the bill would have adverse effects on its industry.

"My opinion: No. 1 - which will all those who have a different rate, the rate will increase from 20 to 25 percent," he said.

Mathieu health insurance companies operate in both group and individual insurance policies and, although HIPAA offers some protection for individuals enrolled passage group policies by employers, for example, the same protections do not exist for the various policies.

Mathieu made a major reason for the lack of protection policies - what he calls the "bump and run" movement - that health insurance customers often sign the policy intention to seek care Medical in the early months of coverage, then not pay the premiums after medical procedures are paid.

Mathieu has also planned a second scenario that could change the "bump and run" move, in which insurance companies no longer offer personal policies and focus solely on group policies.

"It is well-intentioned legislation," he said. "[But] if an insurance company can not break even, they will not. It is not good for business. "

The two legislators, however, said the insurance industry is set up to put the risks, not avoid it, and should take more policies and claims.

"If we have universal health coverage, we must get these insurance companies under control," said Rockefeller. "They are in business to pay for people who are sick."

Dr. Richard Layne, professor of medicine at the WVU School of Medicine, who also practices general internal medicine and geriatrics, said his patients tell him that their payment options for health care are not good , Rockefeller and the effort looks like an attempt to make the market fairer and more accessible.

"We have problems with access to health care and health care costs, and this seems to be a remedy for this," he said.

Layne described a range of problems, such as patients who can not get coverage for specific conditions, patients who could benefit from insurance but can not afford it and patients who have been denied coverage to all.

As for preexisting conditions, he said that the term is very large car insurance companies define them. These conditions could include anything of hypertension of pregnancy.

He also sees the potential for complications, such as insurance companies can choose in which States and the policies they write May choose to do business in health care facilities across the country.

"Most people would agree that [health] is a social good," he said. "But trying to mix social and a good market-based approach is complex."

Jason Butcher, regional public information with the West Virginia Offices of the Insurance Commissioner, said that he would need more information about the bill before he could comment. He did not respond in time for this report.



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