Some Insurers To End Child-Only Policies Rather Than Comply With Health Law Provision

Major insurers plan to discontinue child-only health plans rather than issue coverage under such plans for children with preexisting conditions, something they would have to do beginning Sept. 23 as part of the health law, The Washington Post reports. WellPoint, Cigna and CoventryOne are among the insurers that will end the plans. Those children already covered under the plans would be able to continue, and the companies “will accept children with preexisting conditions in new family policies” (Aizenman, 9/20).

Politico explains, “insurers are worried that children — or, more likely, their parents — might apply for coverage literally on the way to the hospital or doctor’s office and cancel it once treatment is complete. The lack of child-only coverage has the potential to keep healthy consumers out of the market, driving up costs.” The decision by the insurers highlights the “delicate” balance health law changes will encounter in the insurance marketplace, raising questions about how even broader requirements — forcing insurers to accept adults with health conditions, too — will play out in 2014 (Haberkorn, 9/21).

Dow Jones Newswires/The Wall Street Journal: “Health insurers previously have voiced doubt on whether the overhaul does enough to mandate that individuals obtain coverage, given requirements that they insure children regardless of pre-existing conditions as of Thursday, and adults as of 2014. Their concern is that healthier people may decide to forgo coverage if the penalty isn’t tough enough, leaving insurers with sicker and costlier members.” Additional insurers planning to end the plans include Aetna, Humana and UnitedHealthcare, Colorado newspapers have reported (Wisenberg Brin, 9/20).

Specifically, the new rule will “prohibit insurance companies from excluding coverage for children ages 19 and under who have been diagnosed with pre-existing health conditions, such as Type 1 diabetes, high blood pressure, attention deficit disorder, obesity or even acne,” McClatchy/Modesto (Calif.) Bee reports. “According to consumer groups, this change will affect at least five million children under age 17.” Many large employers already cover such children, but smaller employers and individual plans often do not (Rosen, 9/20).

The Hill: News of the insurers’ decisions to drop coverage has thrown a damper on Obama administration plans to highlight changes that go into effect this week under the new health law  “and prompted fierce push-back from the administration’s allies.” Health Care for America Now’s executive director called the decision to end the plans “immoral.” The Hill notes that the “announcement could lead to higher costs for some parents who are buying separate coverage for themselves and their children at lower cost than the family coverage that’s available to them” (Pecquet, 9/20).

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