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Consumer Watchdog to Congress: Put Patients' Bill of Rights Back on the Table
Date:6/4/2009

rage based on an applicant's health history, it is unclear to what extent companies will be allowed to continue to underwrite. Under the Senate plan, Americans with minor health conditions may be forced into the lowest tier insurance policies, which will carry the highest out-of-pocket costs and more limits on benefits. This scenario was a feature of the failed California effort in 2007-08 to mandate health insurance.
  • Dumping the sick. Postclaims underwriting includes the current practice of insurers waiting until someone gets sick with an expensive-to-treat illness to then go back and seek a reason to cancel the policy. Presumably, companies could not leave patients uninsured after a major illness under the plan envisioned by the Congress, but nothing in House or Senate documents bars an insurer from transferring a sick patient into the lowest-benefit policies. As more sick people dominate such policy categories -- called "risk bands" -- the policies available to them become more and more expensive. Ultimately fewer people can afford them and lose their policies or are forced into ineffective coverage (see "junk insurance" above). In the industry this process is called the "death spiral." Other more mundane postclaims underwriting -- for example, raising premiums or out-of-pocket costs after a patient gets sick -- also effectively block access to care and are not barred under the House and Senate plans. The lack of legal accountability and financial consequence for insurers that dump patients, or price them out of policies, when they get sick encourages this practice. (See point 8 below).
  • No accountability. For patients who receive health coverage through a private employer, HMOs and health insurers face no financial consequences for mishandling claims. The Supreme Court decision in Pilot Life Insurance v. Dedeaux stated that "state common law causes of action arising from the improper processing of a claim are preemp
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  • SOURCE Consumer Watchdog
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