Washington D.C. – Today, as insurance companies continue to state their intentions to drop out of the private market for children, First Focus, a bipartisan child advocacy organization, is praising the Administration for keeping the pressure on insurers to make sure that children, especially those with special health care needs, will be able to access insurance coverage as promised in the new health reform law known as the Affordable Care Act.
Bruce Lesley, president of First Focus, issued the following statement:
“While the Affordable Care Act prohibits insurance industry practices that allow denials of coverage for kids with pre-existing conditions, we are deeply disappointed that several major health insurance companies including Anthem, Aetna, Cigna, Humana, UnitedHealth Group Inc., WellPoint, CoventryOne, and Regence are threatening to pull out of the market for children rather than comply with the requirement. Today, we are pleased that the Administration has engaged the National Association of Insurance Commissioners to clarify the reach of the new law and options for states and insurers to ensure that children can get the coverage they need.
“We sincerely regret the decision by insurance companies to renege on the deal they struck with policymakers in which they promised to continue offering private health plans for children. The unfortunate truth is that for many years children’s coverage has been enormously profitable for insurers because children are healthy, the cost of their care is relatively inexpensive, and insurers have been allowed to ‘cherry pick,’ offering coverage only for healthy kids. As a result, taxpayers are often forced to shoulder the cost of caring for the sickest kids, as these children turn to Medicaid and the Children’s Health Insurance Program (CHIP) for coverage.
“As confirmed earlier this week in findings from a House Energy and Commerce Committee investigation, eliminating restrictions on coverage for children with pre-existing conditions is a significant win for families. However, insurers are having a hard time coming to terms with the loss of their ability to selectively deny coverage and services to children with special needs. The time has come for the insurance industry to be responsible players in the health care system. We appreciate the Administration’s efforts to hold insurers to account.
“The families who are most impacted by the actions of the insurers include: parents who work in small businesses and are not offered family coverage, grandparents on Medicare who care for their grandchildren, and returning veterans who get their coverage through the U.S. Department of Veterans Affairs, among others. All of these families rely on this coverage and need to be able to buy insurance for their children in the private market.
“The choice for insurers must be clear: either continue to offer policies for all children or risk losing access to millions of new customers when the new health insurance exchanges are up and running in 2014. We applaud the states like California and New Hampshire, which have let insurers know that they must offer private plans for all children. California has further clarified that insurers who pull out of the private market for children will not be permitted to offer coverage for a period of five years. We also urge states to consider using their Medicaid and CHIP purchasing power to leverage additional conditions of participation from insurance companies to ensure they continue to offer child-only policies.
“Health reform includes many important market reforms that will improve the lives of children. While it is not surprising that insurers are resisting these consumer protections, it is certainly disappointing. Insurers should embrace these changes and play a constructive role in implementing the new law. If they choose to do otherwise, we urge the Administration to be sure that protections are in place to ensure compliance. The health of our children is more important than the bottom line of health insurance companies.”