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Children with pre-existing conditions WILL NOT ALL automatically be covered

Well, in 2014 all children will have to be covered and not subject to rejection. As will anyone who can afford to buy insurance. (UPDATE below.)

But, under Obama's Big Health Insurance Parasite Profit Protection Plan (BHIP-PPP), contrary to statements implying otherwise, only some children with pre-existing conditions will have to be covered by health insurers in six months. This is a major and jarring detail about the vaunted great benefits of the new bill -- One of the benefits being touted as something Dems can run on in November.

From this AP article,, Gap in Healthcare Bill's Protection of Children.

Parents who have believed the Obama hype are going to be very disappointed. It's not nice to lie to parents who have children with serious, dangerous illnesses. Or even less dangerous illnesses.

Can't be turned down for pre-existing conditions? Well, only if you already have insurance and the child subsequently becomes ill. Read and weep. Then consider how these people will vote come November. Oh, Dems, haven't you learned? People hate, hate, hate being mislead and lied to!!!

Thefutureisnow posts this tidbit at FDL:

Under the new law, insurance companies still would be able to refuse new coverage to children because of a pre-existing medical problem, said Karen Lightfoot, spokeswoman for the House Energy and Commerce Committee, one of the main congressional panels that wrote the bill that Obama signed into law Tuesday.

However, if a child is accepted for coverage, or is already covered, the insurer cannot not exclude payment for treating a particular illness, as sometimes happens now. For example, if a child has asthma, the insurance company cannot write a policy that excludes that condition from coverage. The new safeguard will be in place later this year. From AP

Translate: If there’s a family with a sick child that currently is without insurance, they can legally be turned down for coverage. The fine print: That pre-existing condition clause that kicks in at the six month mark only includes:

1. Those families that already have insurance and end up with a child who unexpectedly/suddenly is diagnosed with a serious illness; and
2. uhh, guess that’s it. Oh, wait, the writers of this forward-looking law assumed that, gosh golly gee whiz, if an uninsured family with a sick kid applies to get coverage and the insurance company accepts (whhhaaaatt?), the company can’t write in an exclusion that exempts coverage of that illness at the time of purchase. I know, I know…I can foresee this happening zillions of times.

Seriously: Even as I knew how awful this law is, I’m shocked. Deception and a sales job of the highest order.

It's not for nothing the AHIP 2008 draft was used by Baucus to write the Obama BHIP-PPP. He who writes the bill has the advantage, ainahey?

Now, my reading of the second AP paragraph seems to indicate that if the child is currently insured, but an ailment is not currently covered, it will be now. But I'm not sure about that...developing.

The article continues:

Full protection for children would come in 2014, said Kate Cyrul, a spokeswoman for the Senate Health, Education, Labor and Pensions Committee, another panel that authored the legislation. That's the same year when insurance companies could no longer deny coverage to any person on account of health problems.

In recent speeches, Obama has given the impression that the immediate benefit for kids is much more robust.

The article goes on to give examples of how Obama is misleading the public.

What other suprises will be revealed as the bill is reported on more closely? Oh, my. Our president lies? Or, is he close enough to accuracy for political bamboozlement work?

UPDATE: From the AP article:

Late Tuesday, the administration said Health and Human Services Secretary Kathleen Sebelius would try to resolve the situation by issuing new regulations. The Obama administration interprets the law to mean that kids can't be denied coverage, as the president has said repeatedly.

"To ensure that there is no ambiguity on this point, the secretary of HHS is preparing to issue regulations next month making it clear that the term 'pre-existing exclusion' applies to both a child's access to a plan and his or her benefits once he or she is in the plan for all plans newly sold in this country six months from today," HHS spokesman Nick Papas said.

SNIP

An insurance industry group says the language in the law that pertains to consumer protections for kids is difficult to parse.

"We're taking a closer look at it to see what exactly the requirement will be," said Robert Zirkelbach, spokesman for America's Health Insurance Plans, the main industry lobby.

The lack of explicit language drew this response from the administration, per article by Kaiser Health News:

Responding to the concerns, Obama administration officials said Wednesday the law does prohibit insurers from denying children coverage starting this year, but they will issue clarifying regulations. "The law is clear: Insurance plans that cover children cannot deny coverage to a child because he or she has a pre-existing condition," Health and Human Services spokesman Nick Papas said. "To ensure that there is no ambiguity on this point, the Secretary of HHS is preparing to issue regulations next month making it clear that the term “pre-existing exclusion” applies to both a child's access to a plan and to his or her benefits once he or she is in the plan.”

Reps. Henry A. Waxman, Sander M. Levin, and George Miller, the Democratic chairmen of the three committees with jurisdiction over health policy in the House of Representatives, said Wednesday that the administration response should be sufficient.

“Under the legislation … plans that include coverage of children cannot deny coverage to a child based upon a pre-existing condition," the joint statement said. "We have been assured by the Department of Health and Human Services that any possible ambiguity in the underlying bill can be addressed by the Secretary with regulation."

Ambiguous legislative language makes for good lobbying opportunities. Possibly even litigation....

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Susie from Philly's picture
Submitted by Susie from Philly on

TRI-COMMITTEE CHAIRMEN STATEMENT

WASHINGTON, DC — Reps. Henry A. Waxman, Sander M. Levin, and George Miller, the chairmen of the three committees with jurisdiction over health policy in the U.S. House of Representatives, issued the following statement today regarding the elimination of pre-existing condition exclusions for children, which is included in the historic health care reform law:

“Under the legislation that Congress passed and the President signed yesterday, plans that include coverage of children cannot deny coverage to a child based upon a pre-existing condition. We have been assured by the Department of Health and Human Services that any possible ambiguity in the underlying bill can be addressed by the Secretary with regulation.

“We fully expect that this legislation will prevent insurance companies from denying coverage. The concept that insurance companies would even seek to deny children coverage exemplifies why we fought for this reform effort and will continue fighting to ensure all Americans have access to high quality, affordable care.”

Submitted by hipparchia on

the bill is full of loopholes put there on purpose and lots of places where 'hhs will develop regulations later' and now we're finding accidental loopholes too? eesh.

Aeryl's picture
Submitted by Aeryl on

Cuz that fact is at the end of the first sentence, second paragraph.

"But, under Obama's Big Health Insurance Parasite Profit Protection Plan (BHIP-PPP), contrary to statements implying otherwise, only some children with pre-existing conditions will have to be covered by health insurers in six months."

And nothing in the statement you posted refutes anything jawbone posted, though it's funny because Waxman is contradicting what his own spokesperson had to say about it.

From the AP Article:

Under the new law, insurance companies still would be able to refuse new coverage to children because of a pre-existing medical problem, said Karen Lightfoot, spokeswoman for the House Energy and Commerce Committee

Submitted by lambert on

... that it could take additional regulation to make the wished-for outcome become true. Why is that qualifier even in there, if the legislation covers the problem already?

Especially given that it's a PR personi, Karen Lightfoot, spokeswoman for the House Energy and Commerce Committe, who's pointing out the problem in the first place.

Valhalla's picture
Submitted by Valhalla on

1. I don't think there is a contradiction between Waxman's press release and jawbone's/AP's link. The press release says "plans that include coverage of children." That's the same thing as the article:

if a child is accepted for coverage, or is already covered, the insurer cannot not exclude payment for treating a particular illness, as sometimes happens now.

So, if you don't have a plan, or have a plan which doesn't already cover your kids, I don't see that you'd fall under the "plans that include coverage of children."

2. all Waxman/we have been assured of by the Secretary is that any ambiguity "can" be resolved.

Sure it can. Whether it will is the question. I think assuming good faith on any political actor's part in this whole kabuki is a bad mistake.

It's all pretty irrelevant though, because without enforcement mechanisms, what's going to stop insurers from denying care and having your child languish with their pre-existing illness anyway? Even if it's enforceable, there's nothing to stop them from raising your premiums, so again -- kabuki.

Submitted by jawbone on

WellPoint VP who returned to Baucus's staff to oversee the writing of the Senate bill. Gee, I just can't imagine how confusing or misleading language, possibly very favorable to the BHIPs, made it's way into such a bill....

That sort of thing is much harder to work into a 4-page single payer, Medicare (Improved!) for All type bill, btw.

But ambibuity is the lobbyist's friend. This will make for highly iinteresting and very important rulesmaking..with BHIP lobbyists carefully assisting at every step of the way.

Bringing things to the light of public scrutiny is the best defense against the lobbyists winning most of these battles. The hard part is knowing these things...and then getting the MCM's attention, leading to getting the public's attention. And, finally, following through to affect how, say, HHS will write the regulation....

(Snark alert in Paragraph 1, mmm-kay?)

gqmartinez's picture
Submitted by gqmartinez on

Now both sides can say that the world will end if the other wins the election. Like SCOTUS and abortion, you never really get rid of abortion just play with that idea a lot. Sure, the right wants to overturn Griswald but that ain't gonna happen no matter who is elected president. But, you know, we have to scare people to vote somehow. And that fear leads to great fundraising opportunities as well...

lizpolaris's picture
Submitted by lizpolaris on

10 day old baby dropped from BCBS Texas due to a pre-existing condition - he was born with a congenital heart defect.

Includes bewildered comment from true-believer dad that he thought his child had to be covered because of the new health insurance law.

Quoth the insurance company:
"We will work closely with our customers to keep them informed of any changes that may result from the new law," said Margaret Jarvis, the company's Senior Manager of Media Relations. "We will continue to review the bill's requirements on our business and their respective time frames to ensure full compliance."

Based on what I've read of this new law, the parents better get ready to start living out of their car and eat at food shelters because they are about to suffer a perfectly legal bankruptcy due to medical costs. Yay, new Democratic law!