Melissa Bean's Healthcare101 - Part 4 of 13

From the Palatine Tea Party…

(Palatine, Illinois) – In response to the letter Melissa Bean wrote to the constituents in district 8 dated April 16, 2010. We will respond to each of her statements Melissa Bean made based on emotion with factual responses where she stated the following:

“Across the district, I’ve heard of countless health care challenges families have been struggling with: A mother fearing for her son’s life because he’s hit his lifetime cap on benefits at age 14, contemplating bankruptcy to provide him care. A man unable to start his own company because his pre-existing condition makes it impossible to afford health insurance in the individual market. Moms and dads who have been laid off from work, dreading the expiration of COBRA benefits and access to health insurance for their families. I’m proud to have voted to end these uniquely American stories.

The top priorities I have heard from families in the Eighth district are affordability, portability and security of healthcare coverage. American families with insurance have seen their premiums increase while benefits shrink, and too many have been driven into health care related bankruptcies because of benefit caps or being dropped from coverage when they needed it most. This legislation changes that.

Illinois currently has the highest number of rescissions, or “drops by insurance companies, in the country. Beginning in September, insurance companies will no longer be able to drop coverage of an individual or family when they make a claim, and will not be able to impose lifetime caps on care..”

Firstly, it is ALREADY illegal in ALL 50 STATES to “drop” a policy holder’s coverage when they “make a claim”. In fact, the only time a policy rescission can occur is in the case of fraud. Meaning that a policy holder did not disclose a condition that existed PRIOR to policy purchase. Rescissions are also ONLY ALLOWED by the State Insurance commissioner IF such a “pre-existing” condition were severe enough to have warranted that the applicant be declined for coverage had he or she disclosed the condition at the time of application. To state that an Insurance company can simply “drop” you because you “file a claim” is simply untrue.

That being said, rescissions do occur. But the question we should ask ourselves is WHY? How did the term “pre-existing condition exclusion” even enter our vernacular? For many years now the Insurance industry has been demonized for allowing such rescissions and for denying coverage for those with said “pre-existing conditions”. Is it really their fault? Or does the fault lie with the Federal legislators? Currently 90% of the American Insured are insured on GROUP Health Insurance policies under HIPAA portability laws that were written 14 years ago. HIPAA Portability law states that if you have had 18 months of prior coverage with no lapse of more than 63 days, the new GROUP health insurance policy you are enrolling in MUST cover your pre-existing conditions from day one. Such is the case with all GROUP health insurance policies.

Yet 10% of the American insured purchase their health insurance on the Individual market. As such, they are not protected in the majority of States under existing HIPAA Portability laws. WHY? Why did the federal legislators not include protection for Individual Health Insurance policy holders 14 years ago? If they had done so, the term “pre-existing condition exclusion” would never have entered our vernacular and millions of American’s would have been protected against the exact abuses that you mention in your letter. This is one of MANY reasons why so many American’s no longer TRUST their government to do the right thing.

Palatine Tea Party

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