Dems forgot to include pre-existing conditions for children

**Mark The Shark** · 03-24-2010, 11:54 AM

The Associated Press: Gap in health care law's protection for children

Hours after President Barack Obama signed historic health care legislation, a potential problem emerged. Administration officials are now scrambling to fix a gap in highly touted benefits for children.

Obama made better coverage for children a centerpiece of his health care remake, but it turns out the letter of the law provided a less-than-complete guarantee that kids with health problems would not be shut out of coverage.

Under the new law, insurance companies still would be able to refuse new coverage to children because of a pre-existing medical problem, said Karen Lightfoot, spokeswoman for the House Energy and Commerce Committee, one of the main congressional panels that wrote the bill Obama signed into law Tuesday.

However, if a child is accepted for coverage, or is already covered, the insurer cannot exclude payment for treating a particular illness, as sometimes happens now. For example, if a child has asthma, the insurance company cannot write a policy that excludes that condition from coverage. The new safeguard will be in place later this year.

Full protection for children would not come until 2014, said Kate Cyrul, a spokeswoman for the Senate Health, Education, Labor and Pensions Committee, another panel that authored the legislation. That's the same year when insurance companies could no longer deny coverage to any person on account of health problems.

Obama's public statements have conveyed the impression that the new protections for kids were more sweeping and straightforward.

"This is a patient's bill of rights on steroids," the president said Friday at George Mason University in Virginia. "Starting this year, thousands of uninsured Americans with pre-existing conditions will be able to purchase health insurance, some for the very first time. Starting this year, insurance companies will be banned forever from denying coverage to children with pre-existing conditions."

And Saturday, addressing House Democrats as they approached a make-or-break vote on the bill, Obama said, "This year ... parents who are worried about getting coverage for their children with pre-existing conditions now are assured that insurance companies have to give them coverage — this year."

Late Tuesday, the administration said Health and Human Services Secretary Kathleen Sebelius would try to resolve the situation by issuing new regulations. The Obama administration interprets the law to mean that kids can't be denied coverage, as the president has said repeatedly.

"To ensure that there is no ambiguity on this point, the secretary of HHS is preparing to issue regulations next month making it clear that the term 'pre-existing exclusion' applies to both a child's access to a plan and his or her benefits once he or she is in the plan for all plans newly sold in this country six months from today," HHS spokesman Nick Papas said.

The coverage problem could mainly affect parents who purchase their own coverage for the family, as many self-employed people have to do. Families covered through employer plans typically do not have to worry about being denied coverage because of pre-existing conditions.

Parents whose kids are turned down by an insurer would still have a fallback under the law, even without Sebelius' fix. They could seek coverage through state high-risk insurance pools slated for a major infusion of federal funds.

The high-risk pools are intended to serve as a backstop until 2014, when insurers no longer would be able to deny coverage to those in frail health. That same year, new insurance markets would open for business, and the government would begin to provide tax credits to help millions of Americans pay premiums.

An insurance industry group says the language in the law that pertains to consumer protections for kids is difficult to parse.

"We're taking a closer look at it to see what exactly the requirement will be," said Robert Zirkelbach, spokesman for America's Health Insurance Plans, the main industry lobby.

Heck of a job by the "adults in charge." But at least the bill will give viagra to sex offenders.

**juiceman** · 03-24-2010, 12:03 PM

I guess someone forgot to think about the children.

**pfife** · 03-24-2010, 12:04 PM

good thing the republicans are including pre-existing conditions for children...

oh wait

**billms** · 03-24-2010, 01:32 PM

Mark forgot about schip.

**pfife** · 03-24-2010, 01:41 PM

LOL @ conservatives criticizing the bill because it doesn't go far enough

what next, they claim to be defenders of Medicare?

**Mark The Shark** · 03-24-2010, 01:42 PM

Originally Posted by billms

Mark forgot about schip.

Did "administration officials" forget about S-CHIP too? This articles seems to indicate that pre-existing law wouldn't correct this oversight.

**billms** · 03-24-2010, 01:56 PM

Thats right. Schip will not cover the problem of children not having coverage for pre-existing conditions post HCR because with Schip that problem for the most part does not exist.

Ann Coulter will get up tomorrow. That won't fix the problem of her being an ugly woman - because she isn't an ugly woman.

**Oblong** · 03-24-2010, 02:00 PM

It's got a tampon tax?

Someone said it's called "Ko-Tax".

**Melody** · 03-24-2010, 02:52 PM

New tax on my MIL's oxygen machine too. (The one that medicare doesn't cover, by the way so she has to pay for it herself. You see, if you are self-pay custodial care in a nursing home, you don't need oxygen. Fortunately, she saved her money after my FIL died instead of going on cruises or she'd be in a fix.) Also a tax on her wheelchair, her nebulizer, and other medical necessities that medicare doesn't cover if you are too helpless to take care of yourself, but saved when you were healthy to take care of yourself in your declining years.

If she'd gambled it away in Vegas ten years ago, medicaid would be paying for every single thing she needs. Instead, they're taxing her for taking care of herself. Shameful.

**Oblong** · 03-24-2010, 03:23 PM

Democrats would call that line of thinking selfish.

It's the new world order. Stop saving, stop paying your mortgage. We'll just get someone else to pay for it.

**pfife** · 03-24-2010, 03:26 PM

Originally Posted by Oblong

Democrats would call that line of thinking selfish.

It's the new world order. Stop saving, stop paying your mortgage. We'll just get someone else to pay for it.

I'm sure they're all very glad to have you speaking for them. You are, after all, one of them.

**Melody** · 03-24-2010, 03:27 PM

Honestly, has taxing anything ever made it more affordable? My brain just won't wrap around the strange logic these people have.

**Oblong** · 03-24-2010, 03:42 PM

it makes it affordable for those who don't have to pay for it. But don't be so selfish. Your mother in law should have to pay because she can pay. It's only compassionate.

Don't worry about when we run out of other people's money. We'll just make more.

**Blue Square Thing** · 03-24-2010, 04:37 PM

Originally Posted by pfife

LOL @ conservatives criticizing the bill because it doesn't go far enough

what next, they claim to be defenders of Medicare?

Fwiw that's what's happening here pretty much.

**eastside billee** · 03-24-2010, 04:59 PM

Let's just let this all play out. See how it goes. Fun times ahead!!!

**Melody** · 03-24-2010, 05:38 PM

Originally Posted by Oblong

it makes it affordable for those who don't have to pay for it. But don't be so selfish. Your mother in law should have to pay because she can pay. It's only compassionate.

Don't worry about when we run out of other people's money. We'll just make more.

Hey, I agree. As long as she has the money and is able to pay, she should. But to make her pay MORE in order to subsidize some clown who wants to be a street artist? Sheesh. That's just not right.

She's 86 years old and being diapered and spoon fed like a baby, for pete's sake.

**Melody** · 03-24-2010, 05:44 PM

Now my cousin is spamming my facebook news feed about some baby of a couple she knows. They are trying to get this all over the press, etc. (She's got contacts.) The baby was born, sadly has a heart defect and needed surgery, and now BC/BS has denied payment on the surgery because the parents forgot to fill out the form to enroll said baby in their policy. But that's BC/BS's fault, of course. Unfortunate, but what a couple of morons!

**Oblong** · 03-24-2010, 08:06 PM

Melody, I was being a bit sarcastic, FYI. It is silly that now those who have been responsible have to pay more specifically for people who could have paid but like you said, blew the money. Same as the mortgages. Those who lived within their means are subsidizing those who tapped out equity to fund lavish lifestyles.

**billms** · 03-24-2010, 08:12 PM

Thats true to some extent. But I've been pretty conservative with our mortgage and still feel on top of the world compared to those people in bankruptcy who lost their houses - even if they were tooling around in boats for a while.

**Oblong** · 03-24-2010, 08:14 PM

But now they've dragged our equity down with them.

They are the Tom Hulce character in Parenthood.

**Melody** · 03-24-2010, 08:18 PM

Originally Posted by Oblong

Melody, I was being a bit sarcastic, FYI. It is silly that now those who have been responsible have to pay more specifically for people who could have paid but like you said, blew the money. Same as the mortgages. Those who lived within their means are subsidizing those who tapped out equity to fund lavish lifestyles.

I got that.

Gosh, you hate to see anyone suffer. But at some point, we become enablers and encouraging irresponsibility and flat out stupidity. There is little or no inducement these days to, well, act like a grown up.

**billms** · 03-24-2010, 08:46 PM

Sure there is. You live in a **** hole. Your kids were crappy clothes. You get fat and hypertensive. Your kids get into drugs. The kid down the street gets shot.

There are lots of inducements to grow up - most people listen to them.

**Blue Square Thing** · 03-25-2010, 03:26 PM

Originally Posted by Melody

I got that.

Gosh, you hate to see anyone suffer. But at some point, we become enablers and encouraging irresponsibility and flat out stupidity. There is little or no inducement these days to, well, act like a grown up.

Fwiw I find I have loads of incentives to do so. Absolutely loads.