Dispute over ill child's coverage resolved
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WASHINGTON -- Days after President Barack Obama signed the new health care law, insurance firms were already arguing that, at least for now, they did not have to provide one of the benefits the president has called a centerpiece of the law: coverage for certain sick children.
At issue was how the industry must treat children with pre-existing medical conditions. Mr. Obama, speaking March 19 at a Northern Virginia health care rally, said, "Starting this year, insurance companies will be banned forever from denying coverage to children with pre-existing conditions."
The law's authors said they meant to ban all forms of discrimination against children with pre-existing conditions such as asthma, diabetes, birth defects, orthopedic problems, leukemia, cystic fibrosis and sickle cell disease. The goal, they said, was to provide such youngsters with access to insurance and a full range of benefits once they are in a health plan.
Insurance firms initially contended that the law's wording was not so clear. They agreed that if they provide insurance for a child, they must cover pre-existing conditions. But they said the law does not require them to write insurance for the child, nor guarantee the "availability of coverage" for all until 2014.
Lawyer William G. Schiffbauer, whose clients include employers and insurers, 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 upon hearing some insurers disagreed with their interpretation of the law. "The concept that insurance companies would even seek to deny children coverage exemplifies why we fought for this reform," said House Energy and Commerce Committee Chairman Henry A. Waxman, D-Calif.
Senate Commerce Committee Chairman Jay Rockefeller, D-W.Va., said: "The ink has not yet dried on the health care reform bill, and already some deplorable health insurance companies are trying to duck away from covering children with pre-existing conditions. This is outrageous."
First Published March 30, 2010 12:00 am
