Gov. Fallin to Babies: Pull Yourselves Up by Your Own Booties

Health

When the Affordable Care Act (ACA) was enacted in March 2010, one of the first benefits put into effect was the requirement that insurance companies cover children with pre-existing health conditions. Before the ACA, insurance companies routinely denied kids coverage when they actually needed it – when they were sick. A new policy by Oklahoma Governor Mary Fallin and Insurance Commissioner John Doak would turn back the clock to those bad old days.

Pre-existing conditions are a huge issue for babies. When a baby’s born with heart defects, Down syndrome, or other common problems, they’re – by definition – pre-existing conditions. That makes the ACA’s pre-existing condition denial ban an essential protection for babies and new parents.

Disappointingly, some insurance companies reacted like bad actors to the pre-existing conditions rule by dropping child-only plans, leaving children all across the country uninsured and without options. Governors, legislators, insurance commissioners, and advocates all over the country sided with kids, and in 33 states they managed to maintain or re-start child-only coverage.

Each successful state took its own approach. Some created open-enrollment periods for all kids, one state insurance commissioner declared the actions by insurers as discriminatory under the age-protection policy in their state, and one passed a law providing a strong disincentive for insurers to drop child-only plans. What all of these solutions had in common is that they protected all of the state’s children.

Oklahoma Governor Mary Fallin didn’t. In exchange for insurers returning to the child-only individual health insurance market, she agreed to deny babies up to one year coverage altogether. That’s right – Oklahoma now requires that babies otherwise eligible for coverage in the child-only market remain uninsured. A blog post by Kate Richey, of the Oklahoma Policy Institute, lays out all the gory details.

With CHIP and Medicaid coverage going to 185% of the Federal Poverty Level in Oklahoma, that could leave a fair number of babies uninsured. They could be babies whose parents are self-employed or who are being raised by retired grandparents. Or they could be babies born to parents whose employers don’t offer insurance – nearly 4 in 10 Oklahoma businesses with fewer than 50 employees don’t – or whose employers offer coverage parents can’t afford.

But beyond the numbers, this policy adds insult to injury for kids – putting insurance companies back in charge of children’s health, by singling out a group of Americans so defenseless they literally can’t hold their heads up. We should all expect better.