What Good Is a Law Against Predatory Health Insurance Co's When There Are No Penalties for Predatory Behavior?

H&HS Sec Kathleen Sebelius is putting at least part of the new healthcare "reform" act into practice immediately.

In one of its first steps to carry out the new health care law, the Obama administration announced Friday that it was establishing a temporary insurance pool where uninsured people with medical problems could buy coverage at reduced rates.

Kathleen Sebelius, the secretary of health and human services, said the program would "help provide affordable insurance for Americans who have been locked out of the insurance market."

Federal health officials said the program would be available from late June of this year to Jan. 1, 2014, when private insurers will be required to accept all applicants without varying premiums on account of a person's medical condition.

Under the new law, Ms. Sebelius can sign contracts with states to operate insurance pools meeting federal standards. The federal government can operate the pool directly or hire a nonprofit organization to run it in any state that does not want to do so.

So in 4 years (why the lengthy wait? as if I didn't know....) the insurance companies who refuse to cover pre-existing conditions and practice recission to dump anybody who has PEC's for a variety of fraudulent-to-silly technical reasons are going to have to accept the money of people they have no intention of insuring and that the law CANNOT prevent them from dumping because THERE ARE NO CONSEQUENCES BUILT INTO THE BILL.

This is indeed a "historic" bill. The insurance corpo's will reluctantly agree to accept money from people for health insurance which won't insure anything because the minute clients make a claim it will be disallowed because they

1. missed a payment 3 years earlier
2. did not report a cold they had the winter they were 6 yrs old in their medical history
3. were late with a payment at any time during the period they carried the insurance, even if it was only late by a single day
4. neglected to cross a "t" or dot an "i" on a claim form
5. inadvertently missed one box on the 609 pages of check-boxes on the 1200-pg intake form
6. did not report a medical condition of which they were completely unaware
7. made a claim for a medical procedure the insurance co considered "experimental" even though the medical community has been doing it for years and considers it standard

or any one of 385 other excuses which the health insurance corpo's will have invented during the next 4 yrs as they get ready for the future brought to you by this bill. (Just so you know, all but 2 of the above have actually been used to deny payment of insurance claims. For example, one doctor, an OB-GYN, reported that in one instance payment was denied because she had done a C-section and the company considered it "experimental", and in another instance she was refused payment for a delivery because the company claimed the patient was the "wrong gender", leading to confusion on everyone's part.)

Once you have been refused for any of these reasons, you're put into what the industry calls a "high-risk pool" and your premiums go through the roof. What Sebelius is doing was part of the Massachusetts Plan and what ended up happening was that the insurance corpo's simply rejected anyone who put in a claim for any reason at all, shoved them into the high-risk pool, and let the state take care of them, thus effectively cherry-picking the population until the vast majority of people they were "insuring" against sickness were young and healthy, a demographic that rarely needs the insurance they carry for several decades and are thus pure insurance corpo profit, while the state was paying for everyone who was actually sick.

Premiums in the new program will be set at "standard rates," based on the average premiums charged by private insurers for similar coverage in the individual market.

"If I have cancer, my rate cannot vary based on my having cancer," said Jeanne M. Lambrew, director of the Office of Health Reform at the Department of Health and Human Services.

Ms. Sebelius may establish a minimum set of benefits. The law specifies a limit on out-of-pocket medical costs, which cannot exceed $5,950 a year for an individual in the pool.

So rush out and sign up if you qualify. For the next 4 years, at least, you'll be paying a reasonable price for a service that actually gets provided. Which is more than you had with your HMO before it cut you off.

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