Health reform implementation

Child advocates slam HHS open-enrollment guideline

The Democrats’ new healthcare
reform law takes steps to eliminate restrictions on children’s health
insurance, prohibiting insurers from denying coverage to children with
pre-existing conditions. 

Many private insurers,
however, said the provision would simply discourage parents from enrolling
healthy children. The companies were threatening to drop their “kids-only”
plans unless the administration put some restrictions on enrollment.

On Tuesday, HHS complied.

“To address concerns over
adverse selection, issuers in the individual market may restrict enrollment of
children under 19, whether in family or individual coverage, to specific open
enrollment periods if allowed under State law,” the agency clarified. “This is
not precluded by the new regulations.”

Translation: Insurers can
continue to deny coverage to sick children when parents try to enroll them
outside of yet-to-be-established open enrollment windows.

The children’s groups don’t
like what they see. 

“The health of our children
is more important than the bottom line of health insurance companies,” Lesley
said. 

“Continued action and
vigilance must be taken in order to ensure that children reap the benefits and
promise of health reform, including protections from current private insurance
market practices that deny coverage to children with pre-existing conditions.”

The scaled-back prohibition on denying coverage to sick children
goes into effect Sept. 23.

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