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Washington D.C. – At a Senate hearing this week on Capitol Hill, it was revealed that some insurers have stopped offering child-only coverage in order to avoid compliance with a requirement of the new law. When the Affordable Care Act (ACA) was passed last year, the law prohibited the insurance companies from denying health coverage for children with pre-existing conditions. This insurance industry behavior is making it difficult for some families in a number of states to purchase insurance products to cover their children.
These withdrawals from the private child-only insurance market continue to occur despite the fact that the HHS Center for Consumer Information and Insurance Oversight (CCIIO) has provided states the tools they need to successfully implement the new law, including options such as taking legislative action, using administrative rules, or executive orders to create open enrollment periods, fighting back on age discrimination when child-only plans are eliminated, and utilizing the CHIP buy-in option to provide coverage access to all kids, regardless of a pre-existing condition.
While some states and insurers are dropping out of the child-only market, other states have improved coverage for children. Because of the ACA and state efforts to meet the law’s requirements, children in 33 states across the country (including the six states that had guaranteed issue laws prior to the enactment of ACA) no longer face the barrier of being denied private health coverage because of a pre-existing condition.
Bruce Lesley, president of First Focus, a bipartisan child advocacy group, issued the following statement:
“While the ACA has proven to be successful in improving coverage for children, especially children with special health care needs who are no longer excluded from coverage based on pre-existing conditions, there is still more work to be done. As we learned at this week’s hearing, insurance companies are continuing to use America’s children as pawns to further their bottom lines. We are disappointed that instead of meeting the ACA requirement to ensure coverage for all children, leading insurers continue to put profits ahead of children and have stopped offering policies that cover children. The families who have been impacted by these decisions 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 but need to buy coverage for their children. All of these families need insurance for their kids and purchase coverage for them in the private insurance market.
“Insurers should be condemned for gaming the system on the backs of children. The Administration has offered insurers significant flexibility to design policies for children that meet the needs of both parties. Despite this flexibility, insurers contend that their profits would suffer if they offer child-only insurance products.
“We are heartened that a number of states and insurers have been good actors in implementing the provisions of the ACA that ban denials of coverage based on pre-existing conditions. By providing guaranteed issue, adjusting open enrollment rules, and enforcing age discrimination prohibitions on the side of children, millions of new children now have access to private health coverage. We applaud a number of states, including California, Oregon, Alabama, Hawaii, and Washington, and insurers, including Kaiser Permanente, who are making sure that children with pre-existing conditions have access to appropriate insurance products. First Focus urges other states to follow these successful examples and guarantee compliance with this critical provision of the ACA that garnered significant support from the American public.
“The continued denial of children’s health coverage on the part of some insurers demonstrates again why the protections won with the enactment of health reform are so needed and so important for American children and families and that additional work must be done to guarantee coverage for all of our nation’s children. We look forward to the day when the ACA is fully implemented so that families will have more coverage options and better security that their children will have access to the health care they need and deserve.
“The health of our children should be 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.”