Washington D.C. – Today, the U.S. Department of Health and Human Services (HHS) issued a guidance regarding the enrollment of children with pre-existing conditions under the new health reform law, known as the Patient Protection and Affordable Care Act. The document released today clarifies that insurance companies have the authority to establish open enrollment periods for children with pre-existing conditions wishing to enroll in child-only plans.
The issuance of today’s direction comes on the heels of threats made last week by several insurance companies to stop offering policies for children rather than cover kids with pre-existing conditions without an open an enrollment period.
In reaction to the HHS guidance, Bruce Lesley, president of the bipartisan child advocacy organization First Focus, issued the following statement:
“Despite record profits, insurance companies are using America’s children as pawns to further their bottom lines, threatening to deny coverage to children and forcing HHS to issue a regulation that will allow insurance companies to implement limited open enrollment periods for children who seek health care coverage on their own.
“This threat is a clear illustration that children, particularly those with special health care needs, must have strong federal protections and oversight, to ensure they receive the health care they need to grow and thrive. We are pleased that HHS has agreed to monitor the implementation of new policies that will prevent children from being denied coverage based upon so-called pre-existing conditions, and we strongly encourage them to issue further guidance in order to prevent insurance companies from unfairly limiting access to coverage for those children who need it most.
“This action by HHS, which was pushed by private insurers, also highlights the critical importance and role that America’s safety net programs – Medicaid and the Children’s Health Insurance Program (CHIP) – play in providing health care to these vulnerable children. Medicaid and CHIP provide comprehensive benefits and guaranteed health coverage to millions of vulnerable children without the concerns about medical underwriting and exclusions based upon pre-existing conditions – both of which are typical of the private insurance market.
“The health of our children is more important than the bottom line of health insurance companies. Continued action and vigilance must be taken in order to ensure that children reap the benefits and promise of health reform, including protections from current private insurance market practices that deny coverage to children with pre-existing conditions.”