Congress Should Not Let Insurers Continue to Cheat Consumers in Health Care Reform
Washington D.C. — Wittney Horton of Los Angeles, whose own insurance was cancelled after she sought routine medical care, appeared today before the House subcommittee on Government Oversight and Investigations to urge lawmakers to stop insurance companies from canceling or downgrading insurance coverage when patients get sick.
Horton is part of a class action lawsuit against Blue Cross of California, a subsidiary of WellPoint Inc., the nation’s largest health insurer. Horton represents 6,000 similar victims of Blue Cross "rescissions" – retroactive cancellations of insurance policies after a patient gets sick with an expensive-to-treat illness.
In her testimony to the committee today, Wittney Horton said:
“Americans desperately need health care reform. As my experience shows, owning an insurance policy does not necessarily equal access to health care. If insurance companies are not prevented from canceling or restricting coverage after patients get sick, insurance policies are not worth the paper they are printed on. Insurance companies are making record profits by collecting premiums in exchange for the promises they make to be there when people need them. Make them keep that promise.”
When Horton applied for coverage with Blue Cross, she filled out the long and confusing application to the best of her ability. She gave Blue Cross permission to review her medical records. Blue Cross accepted her application and sold her coverage. After Horton sought routine medical care, Blue Cross scoured Horton’s medical record and retroactively cancelled her coverage. Blue Cross said it would have never sold her a policy if the company had known Horton had “polycystic ovaries,” a condition not disclosed on her application. The rescission letter was the first time Horton had ever heard about this condition. Horton’s doctor had suspected she had the condition, noted it in Horton’s medical file, but never told Horton about it.
In a letter to chairman Henry Waxman (D-CA) last year when the subcommittee began its rescission investigation, Consumer Watchdog urged lawmakers to bar such rescissions unless an insurance company could prove that the patient “intentionally misrepresented” her health condition as required under federal law. Under such an approach, Blue Cross could not cancel Horton’s policy since she was not aware of the condition and therefore could not have lied about it on her application.
The House subcommittee appears to be focused on barring rescission of innocent patients like Wittney Horton regardless of whether comprehensive national reform is enacted this year. The centerpiece of both the House and Senate reform proposals would require every American to show proof of owning an insurance policy or face tax penalties.
"If all Americans will have to prove they own insurance policies, the government must also make insurance companies stick to their promises. That means not letting insurers cancel coverage or dump sick patients into low benefit policies that effectively block access to the care patients need," said William Shernoff of the law firm Shernoff, Bidart, Darras and Echeverria representing Ms. Horton.
Presumably, if Congressional reform plans are enacted, insurance companies could not leave patients completely uninsured after a major illness, because the proposals guarantee availability of coverage regardless of health condition. However, nothing in these proposals would bar a health insurer or HMO from transferring a patient who gets sick into low-benefit policies. Such policies will certainly have skimpier benefits, high deductibles, and high co-pays. For a patient like Ms. Horton, such a degraded policy is almost as effective in blocking access to care as canceling coverage.
“The health insurance industry is promising to provide insurance policies regardless of our health conditions. This is another example of a fake concession by the health insurance industry: the fine print says that though you might have an insurance policy, you’re not covered,” said Carmen Balber, director of Consumer Watchdog’s Washington D.C. office.
For More Information:
** Read Consumer Watchdog’s analysis of health insurer and drug company contributions to the Congressional Blue Dog Democrats Coalition.
** Read Consumer Watchdog’s letter to Congressional leaders listing 10 patient abuses perpetrated by HMOs and health insurers that are currently not addressed by the House and Senate reform proposals.
** Read Consumer Watchdog’s letter calling on Senator Baucus and members of the U.S. Finance Committee to publicly answer ten questions about how requiring all Americans to show proof of insurance or face tax penalties will provide affordable health care.
** Read Consumer Watchdog’s letter to President Obama and Sens. Kennedy and Baucus warning them not to agree to the health insurers’ plan to gut state health care laws.
** Read Consumer Watchdog’s letter to U.S. Senator Ted Kennedy (D-MA) urging that he continue to protect patients consistent with the principles he has articulated during his 40 year career.
** Read Consumer Watchdog’s analysis of health insurer and drug company contributions to members of Congress.
** Read about a recent national poll that found that 65% of voters support giving every American of any age the option of joining Medicare; 60% are willing to pay more in payroll deductions for this option.
** Read about a national poll that found, by contrast, that only 16% of U.S. voters support, and 53% oppose, the insurance industries’ plan of requiring every American to provide proof of private health insurance or face tax penalties or other fines.
Consumer Watchdog is a non-partisan consumer advocacy organization with offices in Washington D.C. and Santa Monica, California. Visit us on the web at: www.ConsumerWatchdog.org
– 30 –