Insurers Balk at Covering Children With Pre-Existing Conditions Before 2014

Insurance companies raise Democratic ire over pre-existing condition coverage for childrenNow that President Barack Obama has signed the healthcare reform bill into law, insurance companies are making the point that they do not have to comply by next September with a centerpiece of the legislation, coverage for some children with pre-existing conditions.  Insurance companies claim that the law — intended to ban all discrimination against children with diseases like asthma, diabetes, birth defects, orthopedic problems, leukemia, cystic fibrosis and sickle cell disease – is not as clear to them as it is to Congress and the White House.  According to the insurers, the law does not require them to guarantee “availability of coverage” until 2014.

William G. Schiffbauer, an attorney whose clients include employers and insurance companies, notes that “The fine print differs from the larger political message.  If a company sells insurance, it will have to cover pre-existing conditions for children covered by the policy.  But it does not have to sell to somebody with a pre-existing condition.  And the insurer could increase premiums to cover the additional cost.”

Congressional Democrats reacted angrily to the insurance companies’ interpretation of the law.  Representative Henry A. Waxman (D-CA), chairman of the House Energy and Commerce Committee, said “The concept that insurance companies would even seek to deny children coverage exemplifies why we fought for this reform.”  Senator John D. Rockefeller IV (D-WV) echoes Waxman’s viewpoint, noting “The ink has not yet dried on the healthcare reform bill, and already some deplorable health insurance companies are trying to duck away from covering children with pre-existing conditions.  This is outrageous.”

The Obama administration plans to issue regulations stating that “the term ‘pre-existing’ applies to both a child’s access to a plan and his or her benefits once he or she is in a plan.”  According to the administration’s interpretation of the new law, coverage for children with pre-existing conditions is intended to begin in September.

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