For the past several years I have been hearing two arguments that continue to drive me crazy. The first is that we have over 40 million Uninsured Americans. The other is that health insurance companies have a long standing practice of dropping you once you get sick.
Let’s start with the first argument. While we do have 40 million Americans without health insurance, I think we need to distinguish between uninsured and uninsurable.
According to a recent Kaiser Foundation study, 48.7% of the uninsured are the young and healthy, these are generally childless adults who take their health for granted. This would account for over 20 Million.
Kaiser accounts 15.3% of the uninsured as the “Passive and Unengaged” group. These are mostly aged 49 and over, with an income of over $66,000 and elect to remain uninsured.
This leaves 28.9% of this group as the uninsurable people in America, this would translate to about 13 million Americans. While I agree this is too many and they need to be helped. There is a big difference between 13 million and 46 million.
Now to the second argument, Insurance carriers dropping you once you get sick. As recently, as last week Congressman James Clyburn stated ““I’ve been hearing from my constituents for the entire 21 years I’ve been in Congress about cancellation letters that they have been getting from insurance companies. As soon as a child is born with diabetes, cannot get on health care policy. Get sick, go for your second treatment, you get a cancellation letter,”
I must refer the Congressman to the HIPAA law enacted August 21, 1996 and signed by President Clinton.
Section 2742 of this law discusses renewability of Individual health insurance coverage. It states,” A health insurance issuer that provides individual health insurance coverage to an individual shall continue to renew or continue in force such coverage at the option of the individual.”
I stress the part that says the option of the individual. It does not say the option of the insurer.
The general exceptions are for non-payment of the premium, Fraud (a misrepresentation of fact, that the insurer would not have issued coverage otherwise).
Some of the other conditions are..
Termination of the plan (carrier ceases to offer individual coverage in a market)
The policy holder moves to an area in which the insurer does not do business.
Therefore, prior to the Affordable Care Act, it was already illegal to “drop” a policyholder’s coverage when they get sick or make a claim in all 50 states.
Maybe our Great Nation’s Lawmakers, have been looking at this the wrong way. These are just the thoughts of this writer. Thanks for reading!