Health Inc.

Sebelius Says Insurers Are 'Reneging' On Kids' Coverage

Health and Human Services Secretary Kathleen Sebelius is after health insurers again.

A sign reads "NO Children ALLOWED."
iStockphoto.com

In a letter to state insurance commissioners, she said the industry is "reneging on a previous commitment" to stop excluding children from health coverage because of preexisting conditions.

Her beef?  A bunch of companies stopped offering kids-only policies on the eve of new requirements under the federal overhaul law to make them write kids-only policies for all comers.

The New York Times says insurance lobbyists argue Sebelius "mischaracterized their commitment" and that the companies never agreed to keep selling child-only policies without restrictions.

Robert Zirkelbach, spokesman for the trade group America's Health Insurance Plans, sent Shots this statement:

Health plans are committed to keeping families’ coverage as affordable as possible. In the small but critically important niche market for child-only policies the regulation has created a powerful incentive for parents to defer purchasing coverage until after their children need it – which could significantly raise costs and cause disruptions for families whose children are currently covered by child-only policies. Plans are therefore having to make very difficult decisions about offering new child-only coverage. We will continue to work with regulators to try and find workable solutions to stabilize the market for child-only coverage

In any event, Sebelius is asking the insurance commissioners for help. In the letter, she outlines some details on how they could make it easier for insurers to continue to offer child-only policies.

She's still steamed at the insurers and blasts their proposal to offer child-only policies at any time to healthy kids while letting in the sick ones during limited enrollment periods. That approach, she said, is "legally infirm."

But, she offers some incentives to the insurers to come along. One of the biggies: They can charge higher rates for sicker kids outside open-enrollment periods, if allowed under state laws.

Whatever happens won't be in effect for too long. Starting in 2014, the health overhaul will kick in at full-strength and insurers won't be allowed to deny coverage to anyone — kids or adults — based on preexisting conditions.

Comments

 

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.