So much for The Children (healthcare reform)

[J]

LA Times link

Big health insurers to stop selling new child-only policies
Anthem Blue Cross, Aetna Inc. and others say they will make the move as soon as Thursday when parts of the new healthcare law take effect. They cite potentially huge and unexpected costs for insuring children.

By Duke Helfand, Los Angeles Times
September 21, 2010|7:02 p.m.


Major health insurance companies in California and other states have decided to stop selling policies for children rather than comply with a new federal healthcare law that bars them from rejecting youngsters with preexisting medical conditions.

Anthem Blue Cross, Aetna Inc. and others will halt new child-only policies in California, Illinois, Florida, Connecticut and elsewhere as early as Thursday when provisions of the nation's new healthcare law take effect, including a requirement that insurers cover children under age 19 regardless of their health histories.

The action will apply only to new coverage sought for children and not to existing child-only plans, family policies or insurance provided to youngsters through their parents' employers. An estimated 80,000 California children currently without insurance — and as many as 500,000 nationwide — would be affected, according to experts.

Insurers said they were acting because the new federal requirement could create huge and unexpected costs for covering children. They said the rule might prompt parents to buy policies only after their kids became sick, producing a glut of ill youngsters to insure. As a result, they said, many companies would flee the marketplace, leaving behind a handful to shoulder a huge financial burden.

The insurers said they now sell relatively few child-only policies, and thus the changes will have a small effect on families.

"Unfortunately, this has created an un-level competitive environment," Anthem Blue Cross, California's largest for-profit insurer, said in a statement declaring its intention to "suspend the sale of child-only policies" on Thursday, six months after the healthcare overhaul was signed.

The change has angered lawmakers, regulators and healthcare advocates, who say it will force more families to enroll in already strained public insurance programs such as Medi-Cal for the poor in California.

The White House weighed in Tuesday, condemning Anthem corporate parent WellPoint Inc. and others that plan to stop selling child-only policies.

"It's obviously very unfortunate that insurance companies continue to make decisions on the backs of children and families that need their help," White House Press Secretary Robert Gibbs said at a news briefing.

The Obama administration had told insurers they could solve the problem by issuing policies only during designated enrollment periods. Some White House officials, however, noted that families who can't find policies might be able to sign up for high-risk pools being set up around the country as part of the new healthcare law.

In California, the stakes may be particularly high for insurers who abandon child-only policies. A bill awaiting Gov. Arnold Schwarzenegger's signature would bar such companies from selling insurance in the lucrative individual market for five years. A Schwarzenegger spokeswoman said the governor had not yet taken a position on the measure.

Assemblyman Mike Feuer (D- Los Angeles), the bill's author, voiced frustration over the insurers' plans and singled out Anthem Blue Cross, whose corporate parent notified brokers nationwide Friday of its decision to exit the child-only business in 10 states, including Colorado, Connecticut, Missouri, Nevada and Georgia as well as California.

"At a time when we are launching a national approach to ensure that all children have access to healthcare, Anthem's actions represent a step backwards," Feuer said. "By threatening to drop child-only policies in California, the company jeopardizes the health of families and children. I call on Anthem to reconsider its plan."

Other regional and national insurers also plan to stop selling insurance policies exclusively for children. Among the companies is UnitedHealth Group Inc., the nation's largest insurer by revenue. It did not say which states would be affected.

"We continue to believe that regulations can be structured that will enable child-only plans to be offered, and we are working toward that goal," spokesman Tyler Mason said.

Aetna said that effective Oct. 1 it would no longer offer policies in the 32 states where it conducts business, including California, Florida, Illinois, Virginia and Pennsylvania.

Cigna Corp. will halt the policies in 10 states, including California, Arizona, Colorado, Tennessee and Texas.

"We made a decision to stop offering child-only policies to ensure that we can remain competitive in the 10 markets where we sell individual and family plans," Cigna spokeswoman Gwyn Dilday said. "We'll continue to evaluate this policy and could reconsider changing this position as market dynamics change."

The explanations left healthcare advocates fuming. They accused insurers of trying to skirt the law's new requirement to cover children with health problems.

"Insurers need to decide if they are in the business of providing care or denying coverage," said Anthony Wright, executive director of Health Access California, a consumer group. "In California, we hope our insurers come to an equitable compromise that allows access for all children and affordability for those with preexisting conditions."

In Colorado, regulators and insurance carriers are trying to work out such a compromise. The state's insurance commissioner met Friday with several insurers, including Anthem, Cigna and Aetna. The two sides did not reach an agreement, but officials remain hopeful they can broker a deal before Thursday.

"Obviously this deadline looms large," said Jo Donlin, director of external affairs for the Colorado Division of Insurance. "The commissioner wants families to have access to the insurance they need. Both sides of this want to find a solution."

Healthcare reform becomes even more of a failure.

[Liberty]

So people freak out about the idea of universal health care. Why not do it in steps?

First, institute a "medicare" for children. Basically, government run health care that covers all children. Children don't need to be on parents' plans, and family plans don't need to exist.

Second, perhaps, some sort of disaster relief insurance. Basically, say, every individual has to pay the first $5,000 per year of medical expenses, and then the government will pick up the rest. You can get insurance if you don't want to pay that first $5,000, or just not go to the doctor unless you have to. You could make it $10,000 instead of $5,000.

That said, I am SO GLAD that our income is low enough that our little one qualifies for the state child health insurance. They pay for all of it, we pay like $50 per month, and that is IT. EVER.

I have to say, though, this makes me think twice about, say, Surlethe taking a summer job that puts us over the income limit. Adding her to our policy would be like $4000 a year, and there are still deductibles, copays, etc.

[Stark]

How totally unexpected this is! If this surprises anyone who wrote the changes to law, they're idiots.

[Chaotic Neutral]

Solution: No age discrimination allowed

Problem solved

[Chaotic Neutral]

Also, what is with Anthem Blue Cross? It seems like they are trying to be the poster-child of evil insurance companies.

[Big Phil]

Also, what is with Anthem Blue Cross? It seems like they are trying to be the poster-child of evil insurance companies.

No, they're doing the eminently logical thing. They're dumping a money losing line of business on the government, which doesn't have the option of declining to cover these kids. There's nothing evil about it; it's an amoral, financially motivated decision.

[Simon_Jester]

Isn't amorality evil? If "evil" is to have any definition that lets it refer to reality, surely acts made without regard to whether they are moral must have the potential to be evil.

[neoolong]

"Insurers need to decide if they are in the business of providing care or denying coverage," said Anthony Wright, executive director of Health Access California, a consumer group. "In California, we hope our insurers come to an equitable compromise that allows access for all children and affordability for those with preexisting conditions."

If an insurer is for-profit, then they're in the business of making a profit. Part of that means lowering costs as much as possible, which includes denying coverage whenever possible.

This really shouldn't be hard to understand.

[Chaotic Neutral]

I know, but amorality aside, it almost seems like they are doing everything they can to look evil.

Just an observation, not need to get philosophical.

[Zaune]

I'd have thought that a better definition of evil would be doing something because it's immoral. If merely acting with complete disregard for the suffering of others is a definition of 'evil' then the term applies to a good-sized chunk of the human race!

In other words, they're actually True Neutral.

[ShadowDragon8685]

I'd have thought that a better definition of evil would be doing something because it's immoral. If merely acting with complete disregard for the suffering of others is a definition of 'evil' then the term applies to a good-sized chunk of the human race!

By that definition, nothing can be described as evil. Not even the holocaust; the Nazis didn't say "Hey, let's be evil and wipe out the JOOOOOOOOOOOOOOOOS!" They decided to wipe out the Jews because they believed that that was the best way to ensure future security and prosperity for Germany.

When you come up with a definition of evil that allows the Holocaust to be disqualified, you're working with a flawed definition and need to return to the drawing board.

[Knife]

OT; I say good. Let them drop it, let the government pick it up and put it's foot in the door for real Health Care Reform.

[CaptainChewbacca]

Amorality isn't inherently evil. It is an absence of the consideration of good and evil. Amorality only becomes immorality when you choose to do that which is not good.

If in a crisis I refuse to share a limited food supply with any outsiders because I'm looking out for my family, that is amoral. If I have enough food to share, but only share with christians, that is evil.

[Highlord Laan]

Shit like this is why the entire insurance industry needs to be either outright nationalized, or pinned to a wall with an iron fist around it's neck.

[Oskuro]

Denying someone access to overpriced luxury items for profit is amoral.

Denying someone access to resources or services required to continue on living for profit is evil.

These companies have decided to trade in a set of resources that people simply can't live without, and thus a purely economical approach is not enough.
That's why there must be strict regulation, an insurance company is, in essence, holding a metaphorical gun to its clients' metaphorical head, not simply making them settle for a smaller tv set.

[Broomstick]

Personally, I think this is a cynical and calculated move by the insurance industry to sabotage so-called health care reform.

But hey, what do I know? I only used to work for them.

As far as I'm concerned it's just another reason to go to single-payer. Get corporations and profit out of coverage entirely, end the health insurance "industry", and make it a public service. Everyone is covered all the time, you don't pay premiums you pay taxes, and those who need care most will be able to get it.

[Alerik the Fortunate]

Since insurance is nothing but the aggregation of resources allocated by statistical risk and doled out as needed, there is nothing, in principle, that private insurance can do better than a central single-payer system. However, people don't think about it this way, and the culture defers automatically to the idea of free market efficiency over government waste. I think Broomstick is right: they are trying to spin this as an inevitable side effect of government regulation rather than an aspect of corporations deciding people are expendable if they do not contribute to the profit margin.

[Liberty]

they are trying to spin this as an inevitable side effect of government regulation rather than an aspect of corporations deciding people are expendable if they do not contribute to the profit margin.

Yes, yes, YES! People are going to see the former rather than the latter! This isn't going to help reform; it's going to HURT reform!

Why? Americans don't know how to think! And I HATE it!

[Broomstick]

Keep in mind that the healthcare industry in this country has been battling against single-payer since the Nixon administration - that's right, 40 years of opposition to the idea, 4 decades of plotting and scheming and developing fallback plans.

Any wonder they do so well at it?

[PeZook]

This is kinda funny. In a horrible way.

Also, I'm a terrible person, but I can't help but smile smugly. It was so obvious this would happen

Unless it's a slick political maneuvre by the O administration (Hah! Sure it is ) to circumvent the fucked-up American legislative system and gradually extend Medicare until it becomes an actual single-payer system.

First we dropped the children, because they didn't bring money.
They picked up the tab and we didn't say anything because we didn't want to deal with them.
Then we dropped the teenagers, because they cost us even more.
And again they picked up the tab.
Then we denied care to the adults, and they went to the government as well.
And now the government dropped us, and everybody smiled and said "Good riddance!"

Ah...a pleasant dream

[Surlethe]

Keep in mind that the healthcare industry in this country has been battling against single-payer since the Nixon administration - that's right, 40 years of opposition to the idea, 4 decades of plotting and scheming and developing fallback plans.

Any wonder they do so well at it?

Even more than 40 years --- for 60, at least: when Truman came out with his single-payer proposal, the AMA came out in force against it and sank it.

[The Yosemite Bear]

ahh children I mean it's not like you can send them to work in factories anymore (I do recall some folks suggesting that in the past) however if the companies can find a way to take money from the parents and give nothing back from cradle till they are in college, it's obviously good for the companies, oh and make everyone work like a dog for employer backed care too. (fuckers raised the rates double digits this month and dropped our perscription coverage till the new contract is renegotiated with our employer on their terms...)

[Zaune]

And people over there still think socialism is a dirty word?

[Alphawolf55]

Whats with this supposed "high cost of coverage" being cited, I always thought children other then the occasional ear infection and shots were one of the cheapest groups to cover.

[Serafina]

Whats with this supposed "high cost of coverage" being cited, I always thought children other then the occasional ear infection and shots were one of the cheapest groups to cover.

Children don't get less sick than your average, non-old adult. But you generally get much less money for them than you get for said adult. So you end up covering about the same costs while getting less money for it.
At least that's what a friend of mine told me, who works at a insurance company. But of course, we are dirty commies and have a (more-or-less) socialized health-care system, so that might not be directly applicable.