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Saturday, July 13, 2024

Oops! Health care bill overlooks children

Health care protest in Michigan (AFP)

Hours after President Barack Obama signed historic health care legislation, a potential problem emerged. Administration officials are now scrambling to fix a gap in highly touted benefits for children.

Obama made better coverage for children a centerpiece of his health care remake, but it turns out the letter of the law provided a less-than-complete guarantee that kids with health problems would not be shut out of coverage.

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 Obama signed into law Tuesday.

However, if a child is accepted for coverage, or is already covered, the insurer cannot 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.

Full protection for children would not come until 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.

Obama’s public statements have conveyed the impression that the new protections for kids were more sweeping and straightforward.

“This is a patient’s bill of rights on steroids,” the president said Friday at George Mason University in Virginia. “Starting this year, thousands of uninsured Americans with pre-existing conditions will be able to purchase health insurance, some for the very first time. Starting this year, insurance companies will be banned forever from denying coverage to children with pre-existing conditions.”

And Saturday, addressing House Democrats as they approached a make-or-break vote on the bill, Obama said, “This year … parents who are worried about getting coverage for their children with pre-existing conditions now are assured that insurance companies have to give them coverage — this year.”

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.

The coverage problem could mainly affect parents who purchase their own coverage for the family, as many self-employed people have to do. Families covered through employer plans typically do not have to worry about being denied coverage because of pre-existing conditions.

Parents whose kids are turned down by an insurer would still have a fallback under the law, even without Sebelius’ fix. They could seek coverage through state high-risk insurance pools slated for a major infusion of federal funds.

The high-risk pools are intended to serve as a backstop until 2014, when insurers no longer would be able to deny coverage to those in frail health. That same year, new insurance markets would open for business, and the government would begin to provide tax credits to help millions of Americans pay premiums.

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.

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9 thoughts on “Oops! Health care bill overlooks children”

  1. “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.

    Because they’ll drop children like a rock in a high risk pool if they can get away with it and pad their bottom line. Health care won’t be reformed until health is considered before profit.

  2. Ah, the slippery slope is a sheer drop off the mountain into the dreaded high risk pool after all.
    Con the congregation whilst on their bleeding knees.
    Oooopsie is the word for today..

    • Bryan…

      I like the way your post describes how government controls the citizens. “Con the congregation whilst on their bleeding knees.”

      Defining the “Con” as being the promise to treat and dress those bleeding knees under the conditions setforth by the band-aid manufacturers, also known as “the Ventriloquist” that manipulates the mouth of government to make the declaration it will save us all from the tyranny of disease…

      Well hell, Bryan – that makes for the perfect storm to shuttle along, at the speed of light, a radical new law, that nobody understands but the band-aid company.

      I’m gonna write that down, might want to use that someday. That pretty much tells it like it is…has been, and probably will be for sometime to come.

      Hmmm, I think I just implied that we have a gullible society. Did I dooo that?

  3. I don’t know how the hell anybody discovered the errors on children’s health care in the bill. Every nutwad in Washington openly admitted that they hadn’t read the Bill.

      • Sherry, the Medicare Act is now over 130,000 pages. Whooaaa…that could be a real challenge for our studious members of Congress, huh?

        • The Medicare Act is codified as a part of title 42, United States Code,. Volume 1 is 1706 pages, volume 2 is 1336 pages, volume 3 is1291pages and volume 4 is 1189 pages. Total is, according to my calculator 5,522 pages. But Medicare is only a small part of that total. So I must respectfully disagree with you on the length of the Medicare Act.

          • GL,

            Darn that Center for Medicare and Medicaid Management.

            Well, it seems that they’ve mislead me. So…I misread the facts. Combine number of pages is about 132,000 pages.

            When GWB was running for election…he displayed 132,000 pages of regulation, etc…and, well, you can see below his comments.

            Quote: Bush pointed to the “132,000-page document.. Bush said during the debates, “The idea of supporting a federally controlled, 132,000 page document bureaucracy as being … the only compassionate source of care for seniors is just not my vision.”


            Lets step back in history to 2005

            According to a 2005 108th Congress Report – Page 146

            “Reglatory burden.—A major reason for the skyrocketing cost of
            health care is the regulatory burden that government is placing on
            the health care system, often without regard to the costs of that
            regulation. Thirty different federal agencies regulate hospitals and
            medical care, in addition to many other regulations created by local
            and State governments and private-sector accrediting bodies. There
            are at least 132,000 pages of regulation in CMS alone, compared
            to only 93,000 pages of regulation for the tax code. A study by
            Duke University has estimated that at least $128 billion per year
            is wasted by this regulatory burden. These costs are unnecessarily
            being borne by employers and employees through increased health
            care premiums, as well as by taxpayers through higher program



            Call me silly, but I guess I believed the sources cited above.

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