SAN FRANCISCO, CA — A North Bay family is already pushing for health care reform in California. Their health insurance was cancelled when their son got sick, joining the growing number of people losing their coverage when they need it the most.
That issue was front and center Monday at a public hearing held in San Francisco. The hearing was convened to discuss new rules proposed by the California Department of Insurance.
The rules would target a practice called rescission, what some critics call "use it and lose it."
Mark Robison and his son Tylor of Santa Rosa testified how the practice has ruined their family.
When Tylor was 9, he had surgery for an undescended testicle. The surgery had been approved by their insurance company Blue Cross of California. 18 months later, the family had their insurance rescinded. Mark said how Blue Cross "rescinded our insurance coverage under the claim that we had fraudulently misrepresented a reproductive problem with one of the family members, i.e. Tylor.
The action left the Robison’s with $18,000 worth of medical bills, a broken marriage, and a torn up family. The Robison’s are suing the insurer.
Blue Cross of California declined to discuss the case, citing patient privacy.
However, consumer watchdogs allege thousands of Californians have been left uninsured by many companies because of the practice.
Jerry Flanagan of with Consumer Watchdog said with the insurance companies, "What they’ve been doing is selling to everybody, then waiting until someone gets sick the wait and see approach and on those folks who get really, really sick its at that point they look at the application and make the determination that they should have never sold coverage in the first place."
California Insurance Commissioner Steve Poizner proposed the new regulations. The regulations must now undergo public comment. This new law would make it difficult to cancel insurance already issued to a Californian. Insurers would have to prove deliberate, outright fraud.
The Association of California Life and Health Insurance or ACLHIC had a representative at Monday’s hearing.
Anne Eowan, Vice President of Government Affairs for ACLHIC sent CBS 5 HealthWatch a statement which reads in part:
"ACLHIC shares the Department’s goal to establish uniformity in the application process and clarity in the underwriting process. Our comments are intended to contribute to that goal while identifying problems that could harm consumers and the health insurance market. Unintended consequences have been identified that could lead to more intrusive medical inquiries, new barriers to timely coverage, lengthy applications, and higher costs for individual seeking affordable health insurance coverage. Our comments offer constructive options for the department’s consideration that will strike a balance to protect the more than 99.9% of applicants that will never be rescinded and promote a fair and understandable process for consumers and insurers alike."
