Dems mad at insurers for pointing out that they forgot to cover kids with preexisting conditions

posted at 4:38 pm on March 29, 2010 by Allahpundit

I blogged this screw-up last week, but much to my surprise, insurance companies appear ready to make an issue of it. That may be useful in calling public attention to how shoddily the bill was drafted and how The One, who promised immediate coverage for kids, oversold it, but is the “we don’t have to insure sick kids after all!” hill really the one the industry wants to die on?

To insurance companies, the language of the law is not so clear.

Insurers agree that if they provide insurance for a child, they must cover pre-existing conditions. But, they say, the law does not require them to write insurance for the child and it does not guarantee the “availability of coverage” for all until 2014.

William G. Schiffbauer, a lawyer whose clients include employers and insurance companies, said: “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 were furious when they learned that some insurers disagreed with their interpretation of the law.

Tom Maguire got deep, deep into the weeds of the statutory language this morning to try to hash this out. In a nutshell, because the Dems were nervous about delaying the benefits of their glorious boondoggle until 2014 — which was necessary, as you’ll recall, so that they could game the CBO’s first-decade cost estimate — they decided to speed up coverage for kids with preexisting conditions to this year. Except, in their haste, they did a crappy job with the drafting and only amended one of the four relevant statutory sections. Result: If insurers choose to sell a policy to a sick kid’s family, they have to cover his preexisting condition, but there’s nothing in the law — until 2014 — that requires them to sell a policy in the first place. The money question per Maguire is whether this really was negligence at work (and negligence on the GOP side in failing to catch it and exploit the issue) or whether the Dems fully intended to permit this loophole for the next four years and are now caught because The One misunderstood it and/or overhyped it.

I’ll give you another option, though. What if the Dems purposely left this section ambiguous in hopes that it would invite a challenge from the insurance industry and, ideally, the GOP? The exemption for preexisting conditions is probably the single most popular provision in the bill; extending that exemption to sick children would, I suspect, poll somewhere in the neighborhood of 90 percent. What better way to sell the bill to a wary public than to manufacture a showdown with the evil, heartless insurance companies and their Republican “corporate cronies”? If nothing else, a vote in Congress to correct the drafting “error” and close the loophole would be a poison pill for the GOP. If they vote no, they “hate sick kids”; if they vote yes, the base will take it as a sign that they’re not serious about repeal. All of which is to say, if this really is an accident, it’s a very happy one for Democrats.


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Barack Obama lied about children’s coverage!

drjohn on March 29, 2010 at 5:48 PM

F

CWforFreedom on March 29, 2010 at 5:55 PM

The Dems will attempt to blame the GOP anyway, so let them. This is proof of how poorly written the health care “legislation” is.

Hera on March 29, 2010 at 5:57 PM

Insurers now have plenty of motivation to see the bill modified or repealed. Congress stabbed them in the back with higher taxes and when it required them to cover people with pre-existing conditions but decided not to enforce the individual mandate to purchase insurance. There are no legal consequences for ignoring the individual mandate.

Now people can thumb their noses at the individual mandate, avoid purchasing insurance and have guaranteed issue when they have a serious illness. I keep saying that when the guaranteed issue kicks in hospitals should sell health insurance in the ER and it’s true. It’s a win-win for the sick patient and the hospital, but a terrible deal for insurers and responsible people who will be paying significantly higher premiums to fund our irresponsible brethren.

Maybe insurers will start to speak up now that they realize how completely Congress sold them out and how unpopular HCR is. The farther Obama’s approval ratings drop, the more emboldened they’ll become. He can’t protect them from the pitchforks when they’re being sharpened for him.

(On the other hand, enjoy your schadenfreude as Aetna, United Healthcare and all the others who made their deal with the devil to impose this monstrosity on us reap the consequences.)

obladioblada on March 29, 2010 at 6:00 PM

I’d hold my head high and vote no.

Alden Pyle on March 29, 2010 at 6:01 PM

I would not attribute anyting to cleverness when it comes to this bill. Stupidity is far more likely.

rockmom on March 29, 2010 at 6:04 PM

The exemption for preexisting conditions is probably the single most popular provision in the bill; extending that exemption to sick children would, I suspect, poll somewhere in the neighborhood of 90 percent.

Am I the only heartless bastard out there that thinks it’s ridiculous to require a company that insures against POSSIBLE issues to extend coverage to someone with KNOWN issues?

I know we’ve all heard the analogy before, but, it really is like insuring a house once it’s already on fire.

If you have a pre-existing condition and you are looking for insurance to cover it, you are basically asking for the company’s other policy holders to pay your bills for you. You aren’t entering into a risk pool and paying in on the chance that you’ll need to pull money out. You are asking to be able to pay in $200/month when you already know that you’ll need to pull out $1000/month (or more).

Of course, it’s hard to talk numbers when you are dealing with sick children, but, if their parents can’t afford their medical care, they should be looking for a charity program that was set up to be a charity program. They should not ask the government to force an insurance company to be a charity program.

JadeNYU on March 29, 2010 at 6:05 PM

SCHIP, fo heaven’s sake! You are paying for it already. These children ARE covered.

katy the mean old lady on March 29, 2010 at 6:06 PM

angryed on March 29, 2010 at 4:56 PM

I second the motion.

chemman on March 29, 2010 at 6:09 PM

They can try to spin it all they want, this just highlights how sloppy this whole process was. 1/6 of our economy and this is what we get.

Daemonocracy on March 29, 2010 at 6:15 PM

Why do that?

Kensington on March 29, 2010 at 5:09 PM

Maybe he subscribes to the Strong Horse Theory.

chemman on March 29, 2010 at 6:16 PM

One thing you forgot Allah:

If insurance companies take the hit now, premiums GO UP FOR EVERYONE NOW.

Were I a Republican, I would NOT vote for anything to do with Barry’s bill. They wrote it, they passed it, they OWN IT!

GarandFan on March 29, 2010 at 6:27 PM

GarandFan on March 29, 2010 at 6:27 PM

i would take the hit from the dems…this boondoggle is going to blow up their faces and the GOP shouldn’t get suckered into it

cmsinaz on March 29, 2010 at 6:31 PM

Gotta do it for the childwen!

According to ObamaCare definitions, can the children with non-covered pre-existing conditions be up to 26 years old?

The Nanny State at work. When I was 26 years old, I was already working at my second full-time job. That wasn’t THAT long ago, when Ronald Reagan was President!

Steve Z on March 29, 2010 at 6:47 PM

The true villains here are the Dhims. They own this ill-conceived pile of dung and it was their own incompetence that led to this oversight.

Those of us NOT in government are acutely aware of the penalty for gross incompetence on the job: termination. The Dhims deserve no less come November 2.

ya2daup on March 29, 2010 at 6:49 PM

If AP’s scenario comes to pass the GOP should vote for this error to be corrected. I doubt that GOP voters would take issue with this particular section of the bill. It is, after all, one of the very few sections of this bill we should approve. I do not see an issue here. Please do not make it one Hot Air.

jeanie on March 29, 2010 at 6:53 PM

If the Dims go ahead and mandate coverage for pre-existing conditions now, how do they explain the fact that premiums will be SKY HIGH? Or are they also planning on picking up some of the charges? If they pick up some, won’t they then have to re-do their CBO scoring?

GarandFan on March 29, 2010 at 6:59 PM

Bah. No way the dems planned this. They wanted this thing done so badly they could have included provisions for mandatory abortions on every other pregnancy for the next ten years, and they still would have marched to the Kool-Aid tub to vote for it.

Maybe the Repubs should be proactive on this one. Introduce a bill for SCHIP to cover the kids under 18 with pre-existing conditions. And take the money out of some other hideous, unpopular program to pay for it. I think it’s already part of the SCHIP law for these children to be covered, but they need to parade this thing out and rub dem faces in it anyway. Every day. Every way.

ObjectionSustained on March 29, 2010 at 7:03 PM

If AP’s scenario comes to pass the GOP should vote for this error to be corrected. I doubt that GOP voters would take issue with this particular section of the bill. It is, after all, one of the very few sections of this bill we should approve. I do not see an issue here. Please do not make it one Hot Air.

jeanie on March 29, 2010 at 6:53 PM

Sorry, jeanie… You are asking for charity for sick children…hmm…Is ADD considered a preexisting condition? If you have a sick child and have REFUSED to cover them…There is welfare. SCHIP, Medicaid, sorry your kid is sick. Maybe your church will help.

Jeff2161 on March 29, 2010 at 7:03 PM

If your a lazy, but wealthy parent… The only way your child would not be covered under existing programs, Put your child up for adoption.

Jeff2161 on March 29, 2010 at 7:05 PM

I know, But, but, but, it’s for the chirrun…Will this also pay for dope addiction, std’s,pregnancy for the chirrun?

Jeff2161 on March 29, 2010 at 7:07 PM

Promoting charity for sick children? It could be interpreted that way I suppose but I prefer to think of it as one of the more sensible parts of this outrageous bill. In any case, the GOP legislators will have little choice but to vote for it should it come up.

jeanie on March 29, 2010 at 7:11 PM

CBS carried the story this evening and as expected the spin was “evil insurance companies.”

farright on March 29, 2010 at 7:20 PM

All of which is to say, if this really is an accident, it’s a very happy one for Democrats.

Except for one thing Ap- the bill passed and a vote wasn’t taken on this particular issue. If the Dems hoped that would happen, they must be disappointed. If they hoped the insurance companies would pick up on it after it passed- what’s the point? They would have already won the debate and the insurance companies no longer matter.

I think it more likely that in trying to draft and revise a bill the size of this one without a great deal of technical scrutiny, they just plain missed it. After all, competence is not a strong suit for anyone blindly driven to an agenda.

BKeyser on March 29, 2010 at 7:21 PM

Anyone sellin insurance against politicians. Business is stymied as they don’t what these clowns will do next even as the thieves in DC speculate on capturing our 401k’s and annuities to help make SSI solvent.

We are to pay more to save the funds that the politicians stole.

Polishin my guns and stockin up on ammo.

Can I say that with Janet Napoleon on the loose?

dhunter on March 29, 2010 at 7:33 PM

The Dems did plan this, but they messed up on the details.

They fully intended to force insurers to accept people with pre-existing conditions this year. This was supposed to kick in before the 2010 election and ride them back to victory on a wave of public enthusiasm. It’s just that they were in such a hurry to draft a gazillion page bill that could be rigged to meet their numbers that their draftsmanship was shoddy.

The remainder of the bill was intended to force insurers to fail. They thought they were forcing guaranteed issue this year, but an individual mandate after the 2012 election. That was supposed to give them the supposedly popular stuff first, but without any of the obligations til later. This would necessarily drive up premiums now, especially for young people who are also now required to pay extra to subsidize older people.

The failure to provide legal consequences for a failure to honor the individual mandate was also deliberate. They’re not responsible for forcing people to buy insurance and the failure of the healthy to buy insurance will further drive up premiums.

Once premium rates are catastrophic and people are still uninsured, then they can blame the evil insurance companies and push single payer.

This was assuredly preplanned, albeit incompetently drafted.

The stupid insurance companies thought that if they weren’t at the table they were on the menu. The fact is that they were both and contributed heavily to this mess.

obladioblada on March 29, 2010 at 8:04 PM

I think the Republicans should work with the Dems on this. They could put it as something they were going to work on but the Democrats were so busy pushing this bill through that they did not read the bill.
My Grandson was born with heart problems. His parents have insurance and he has had the operations he needed. The problems come if his parents change jobs or move to a different state. His insurance may not transfer. His health care now is not that much different than a child born without problems.

jeannie on March 29, 2010 at 8:35 PM

My Grandson was born with heart problems. His parents have insurance and he has had the operations he needed. The problems come if his parents change jobs or move to a different state. His insurance may not transfer. His health care now is not that much different than a child born without problems.

jeannie on March 29, 2010 at 8:35 PM

Loss of health care benefits while changing plans and employers hasn’t been an issue for years. Unless there is a break in coverage for a significant period of time. Even at that, COBRA allows employees to pay to maintain their own coverage for as long as 18 months after they leave a job.

If your grandson was born with heart problems, has had several operations and was covered under his parents’ plan, he most likely has had continuous coverage for a period that exceeds the maximum exclusion period for a pre-existing condition under the Health Insurance Portability and Accountability Act of 1997. Moving from state to state has nothing to do with it.

Perhaps his parents should research this if they indeed plan a job change. We research it thoroughly before each and every job change. Our son has never lost his coverage because of a change in our employer or insurance, nor has it ever been an issue. His health issues go well beyond heart problems.

Before passage of the Health Insurance Portability and Accountability Act (HIPAA) in 1997, people had to worry about health insurance coverage for preexisting conditions like diabetes, heart disease, or cancer. If you changed jobs and had to change insurers, you might not have been able to get some of your care covered because of the preexisting condition exclusion.

Today, HIPAA helps to assure continued coverage for employees and their dependents, regardless of preexisting conditions. Insurers can impose only a 12-month waiting period for any preexisting condition that has been diagnosed or treated within the preceding 6 months. As long as you have maintained continuous coverage without a break of more than 63 days, your prior health insurance coverage will be credited toward the preexisting condition exclusion period.

If you have had group health coverage for at least 1 year and you change jobs and health plans, your new plan can’t impose another preexisting condition exclusion period. If you have never been covered by an employer’s group plan and you start a new job that offers such a plan, you may be subject to a 12-month preexisting condition waiting period. Federal law also makes it easier for you to get individual insurance under certain situations. You may, however, have to pay a higher premium for individual insurance if you have a preexisting condition.

obladioblada on March 29, 2010 at 9:08 PM

Couldn’t they just pull an Obama and vote ‘present’ on the issue?

SalHansen on March 29, 2010 at 9:20 PM

a vote in Congress to correct the drafting “error” and close the loophole

I see this as more bad news for the Democrats. They take a vote to close the loophole and everyone’s premium will skyrocket. Sure Obama promised kids with pre-existing conditions would be covered, but he also promised your premiums would be $2500 cheaper. When middle-class Americans see their premiums increase, they will turn out in huge numbers against the Democrats.

What else have the Democrats over-looked? That large employeers like Catipillar, At&T, John Deere will take a huge loss (millions/billions) and will have to cut coverage and/or be forced to layoff people.

Oh and does Stupak hate all children the unborn and the living??

TN Mom on March 29, 2010 at 10:30 PM

Call me paranoid, but I think Obama would rather see babies with birth defects end up in the trash can. That would be a “win-win” for everyone, right?

He is, as I’ve said before, an evil, evil man. So no, I don’t think it was an oversight. Nancy herself sees abortions as a big cost-saver.

disa on March 29, 2010 at 10:34 PM

p.s. Sarah’s death panels are – or will be – quite real, you see.

disa on March 29, 2010 at 10:35 PM

If nothing else, a vote in Congress to correct the drafting “error” and close the loophole would be a poison pill for the GOP. If they vote no, they “hate sick kids”; if they vote yes, the base will take it as a sign that they’re not serious about repeal. All of which is to say, if this really is an accident, it’s a very happy one for Democrats.

They should demand to excise all of the gangrene in this atrocity of a bill and start over. Or vote present.

disa on March 29, 2010 at 10:39 PM

Related parody: Democrats to Require Individuals to Buy “D’oh!bama” Insurance to Cover Losses Resulting from Flaws in ObamaCare Law http://optoons.blogspot.com/2010/03/democrats-to-require-individuals-to-buy.html

Mervis Winter on March 29, 2010 at 11:04 PM

What if the Dems purposely

Funny! You had me for a minute, thinking the likes of Waxman, Waters, Pelosi, (insert generic tar 0bama supporter here) could ever actually design something like that, purposely, and weren’t just being their low IQ selves.

MNHawk on March 30, 2010 at 8:02 AM

Of course, it’s hard to talk numbers when you are dealing with sick children, but, if their parents can’t afford their medical care, they should be looking for a charity program that was set up to be a charity program. They should not ask the government to force an insurance company to be a charity program.

JadeNYU on March 29, 2010 at 6:05 PM

I was the recipient of charitable care-Shriner’s Hospital in Dallas-when I was a kid.
It’s there. But if you can pay your own way, that is your duty.

SCHIP, fo heaven’s sake! You are paying for it already. These children ARE covered.

katy the mean old lady on March 29, 2010 at 6:06 PM

I often here people saying that the eligible are not signing up for they free care & so the passing of this bill will somehow make this better by FORCING them to ‘sign up’.
How ingenius.

Badger40 on March 30, 2010 at 2:04 PM

Comment pages: 1 2