Sept. 23--As key provisions of the federal health overhaul take effect today, lawmakers
and health care advocates are expressing outrage over a plan by some insurers
to stop selling child-only policies.
"I don't want to look like I'm gloating, but this is exactly what some of
the concerns were before the bill passed," said U.S. Rep. Jason Altmire of
McCandless, a Democrat and former UPMC executive who voted against the
legislation. "It's not a surprise, and I'm very disappointed."
Health plans including Aetna Inc. and Cigna Inc. will no longer sell some
child-only policies because they say it will be too costly to comply with the
new federal requirements. They worry parents will buy insurance only after
their children become sick, increasing the pool of patients who need costly
care. The law calls for insurers to cover people younger than 19 under their
parents' policy regardless of their health.
Highmark Inc., the largest insurer in Western Pennsylvania, said the
health law is prompting an assessment of some of its child-only policies.
Spokesman Aaron Billger said that even if those plans are scaled back,
Highmark will continue to offer coverage to anyone with pre-existing
conditions through other products with child-only lines.
"It's certainly sad but not surprising," said Beth Heeb, executive
director of Consumer Health Coalition, Downtown, an advocate for people
without insurance. "Health insurers are continuing to do what's in the best
interest of their companies rather than in the best interest of consumers."
Billger said Highmark will make sure it fully complies with the health
law. It was signed by President Obama six months ago, and many Republicans
have vowed to repeal it.
"Dropping health insurance plans for children is inexcusable," said Sen.
Bob Casey, D-Scranton. "I'm calling on the insurance companies to reverse this
decision and to do the right thing for kids, families and the economy. I am
also asking (Health and Human Services) to explore the tools at their disposal
to compel insurance companies to not hedge on their previous pledge to not
drop coverage to children."
The action by the health insurers will apply to new coverage sought for
children and not to existing family policies or those provided to children
through their parents' policies. Officials at Aetna, which has customers in
Pennsylvania, did not return calls for comment.
Several key provisions kick in today but the majority will not take
effect until 2014.
Starting today, health insurers must provide free coverage for preventive
care such as mammograms and must allow young adults to stay on their parents'
plan until they are 26. Up to 2.4 million young adults could benefit from
this, according to White House projections. In addition, insurers will not be
able to rescind coverage because of a serious illness.
Obama talked up the law Wednesday during a visit to the home of a
Virginia family, but acknowledged Americans are confused about the
legislation.
"Sometimes I fault myself for not being able to make the case more
clearly to the country," he said.
A poll by The Associated Press found just 30 percent of people in favor
and 40 percent opposed to the legislation. Another 30 percent were neither in
favor nor opposed.
Altmire said he voted against the nearly $1 trillion health care bill
partly because it did not address high costs. Health care expenditures in the
United States surpassed $2.3 trillion in 2008, accounting for 16.2 percent of
the gross domestic product.
"The missing piece is bringing down the cost of health care," Altmire
said. "What this bill does is shift the burden from one group to another. It
doesn't say we're going to lower the premiums. It just says we're going to
shift that cost."
As 2014 draws closer, Altmire expects insurers to scale back other
programs.
"As costs continue to go up, the people who are paying the bills are
going to make decisions on how to bring the bill down," he said.
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