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Issue of coverage for sick kids unclear in Obama health reform law

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In its haste to pass health care reform, it appears that Congress did not think through many of the unintended consequences of the law’s language (there are so many that this blog post can barely begin to touch on them), but one consequence appears to fly in the face of the Obama Administration’s assertions, and the intent of the bill itself.

Take the issue of insurance coverage for children with pre-existing medical conditions. A noteworthy and compassionate aspect of the flawed law, one part that should have been addressed singularly in a strategic manner, but nonetheless a much-needed reform, regardless of which side an observer sits on the health reform debate.

From the message presented by President Obama and Democrats such as House Speaker Nancy Pelosi, one would believe that, as they have stated innumerable times in print and on TV, parents who have children with pre-existing conditions will be able to obtain coverage for those children beginning this year. Right?

Wrong.

Here is what David Axelrod said on March 28 on CNN’s State of the Union program: “This year…kids with preexisting conditions will get coverage for the first time. They won’t be excluded any more.”

But the law — written in haste and without input from the health insurance industry — is vague, with many reading it to say that only children who are currently covered under a health plan will now have their pre-existing conditions covered. Nowhere in the language of the law does it state that insurers are required to guarantee issuance of coverage to children with pre-existing conditions. At least, not until the year 2014.

The New York times, in writing about the ambiguity of the law, interviewed an attorney who is an expert in the insurance field and who has represented insurance companies, and who has likely read the legislation with a magnifying glass. “The fine print differs from the larger political message,” the Times quoted attorney William G. Schiffbauer as saying. “If a company sells insurance, it will have to cover pre-existing conditions for children covered by the policy. But it does not have to sell to somebody with a pre-existing condition. And the insurer could increase premiums to cover the additional cost.”

Technically, the bill prevents health insurers from denying coverage to children who already have coverage. But it does allow them to refuse to offer a policy to children who are under 19, at least until 2014 when additional regulations kick in.

So which was Axelrod stating? That kids with conditions but no insurance can get insurance this year, or that kids with conditions and who have insurance with exclusions for that condition will have the condition covered beginning this year?

Hard to say.

MSNBC, arguably one of cable TV’s biggest supporters of Obama and his agenda, ran a story from the Kaiser Foundation that says the new health reform law doesn’t adequately explain childhood pre-existing condition coverage, and may actually lead to higher insurance premiums for all.

While no one can argue that covering children with pre-existing conditions is one of the fundamental cornerstones of any health reform legislation, perhaps Congress and the president would have been well-advised to follow the will of the American people. Citizens wanted — and according to the polls still want — its lawmakers to take the time to craft individual bills that would build upon each other, instead of the quagmire that we now find ourselves in. Spending months and years attempting to dissect and digest the nearly 3,000 pages of this law will find us debating singular issues such as this.

Meanwhile, the American people won’t get what they want and deserve: Health care reform that is specific, clear and with few hurdles to implementation.


Issue of coverage for sick kids unclear in Obama health reform law via IFAwebnews .


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