Lawmakers protest healthcare bill’s caps on benefits over policyholder's lifetime

A cadre of Democratic lawmakers and patient groups is urging congressional Democratic leaders to abandon plans to permit health insurance companies to set lifetime limits on their customers’ benefits.

In letters sent to House Speaker Nancy Pelosi (D-Calif.), Senate Majority Leader Harry Reid (D-Nev.) and the other senior Democratic lawmakers authoring the final version of healthcare reform legislation, 29 House Democrats and seven Senate Democrats press the leaders to adopt the House’s take on the bill, which would prohibit insurers from establishing a dollar cap on how much they will pay out during a policyholder’s lifetime.

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“Individuals with chronic diseases and disorders must not be impeded in accessing necessary health care nor should they be impoverished with unreasonable lifetime limits on benefits,” Democratic Rep. Patrick Kennedy (R.I.), Republican Rep. Cathy McMorris Rodgers (Wash.) and 28 colleagues wrote Friday. Democratic Sens. Byron Dorgan (N.D.), Al Franken (Minn.) and five other senators wrote a separate letter Thursday.

Sixty-three groups, including the American Heart Association, National Kidney Foundation, Easter Seals and groups representing cancer, brain and spinal cord injury, and other patients penned a similar letter on Jan. 8.

Under the House-passed healthcare reform bill, insurance companies would be prohibited from establishing annual or lifetime limits on benefits. Although the Senate-passed bill also forbids annual limits, it would permit lifetime limits in existing insurance plans by “grandfathering” those policies while forbidding new plans from establishing them.

Throughout the debate on healthcare reform, Democrats have routinely promised their legislation would free people from the anxiety that high medical bills would lead to financial ruin, prompting some lawmakers and patient groups to protest when the lifetime caps were introduced into the bill this autumn.

“By preserving lifetime limits, patients in grandfathered plans will be left behind as strong patient protections are extended to those who are newly insured,” the senators wrote.

The House letter is signed by the leaders of two prominent Democratic caucuses: Reps. Raúl Grijalva (Ariz.) and Lynn Woolsey (Calif.), the co-chairpeople of the Congressional Progressive Caucus; and Rep. Barbara Lee (Calif.), chairwoman of the Congressional Black Caucus. Other members of both caucuses are also represented.

In addition to Dorgan and Franken, Democratic Sens. Sherrod Brown (Ohio), Carl Levin (Mich.), Bob Casey Jr. (Pa.), Kirsten Gillibrand (N.Y.) and Barbara Boxer (Calif.) signed the Senate letter.