Calling the insurance industry the “bane” of health care providers, Sen. Jay Rockefeller, D-W.Va., has introduced legislation that would prevent insurers from denying coverage to individuals because of pre-existing medical conditions.
The Pre-existing Condition Protection Act would eliminate pre-existing condition exclusions in all insurance markets, according to the senator. The bill also would require the federal government to prepare reports on the extent of how many people are allegedly being denied coverage.
In a conference call with reporters, Rockefeller said the law is a crucial part of the health care reforms that Congress is considering.
“If we are going to have universal health care, we have got to get the insurance companies under control,” he said.
Rockefeller and U.S. Rep. Joe Courtney, D-Conn., said 133 million Americans live with chronic illnesses that could exclude them from coverage.
Congress took up the issue in 1996 with passage of the Health Insurance Portability and Accountability Act, or HIPAA, which prevented employers’ group health plans from limiting or denying coverage to an employee for a pre-existing medical condition.
Rockefeller and Courtney said that while HIPAA covered many cases, many people still could be excluded from coverage. The senator specifically pointed to pregnant women, who he said were protected under group plans but not under individual plans.
Both lawmakers didn’t see the legislation raising premiums for people who already are insured. They said an influx of new enrollees would more than make up for the costs to insurance companies.
Rockefeller was particularly critical of the insurance industry, calling it the bane of doctors and hospitals. He said he wasn’t very sympathetic to the insurance companies given that they knew they were getting into the business of paying for health coverage.
“That is what insurance companies are meant to be doing,” he said.
Robert Zirkelbach of the America’s Health Insurance Plans, an industry organization, said that nine of 10 people who apply for health insurance are offered coverage, although he didn’t have any figures for how many of them accepted what was offered.
Zirkelbach also said states that have adopted proposals similar to the one Rockefeller is suggesting have found that many people won’t seek coverage until they absolutely need it, knowing companies cannot deny them. The result is higher premiums, he said.
“There was an incentive for people to wait until they were seeking coverage,” he said.