Consumers in Individual Health Insurance Market Face Rejection, High Premiums
Acne, yeast infections and weight are some of the reasons people face rejection or "sky-high premiums" in the individual market for health insurance coverage, the Orange County Register reports. Some estimates say 20% of people who apply for insurance in the individual market are rejected, although a recent study by the Kaiser Family Foundation concluded the rejection rate is around 35%. And a study by PriceWaterhouseCoopers LLP, found the number of Americans considered by health plans to be "medically uninsurable" is close to two million. According to the Register, people who are rejected when seeking coverage in the individual health insurance market are typically "left out of the equation" when lawmakers debate about how to expand access to health coverage. President Bush's tax-credit plan, for example, would not help those who are rejected, and "would be of only modest help" for those facing high premiums. Advocates for the uninsured call for market reform with guaranteed issue -- anyone who applies for insurance must be accepted, like in Massachusetts. Health insurance industry representatives, however, say that guaranteed issue "would either kill the industry or send everybody's premium into the stratosphere." The Register reports, however, that "though opinions may differ sharply" on what reforms should be considered, "nobody denies that something should be done to make the individual market more accessible." According to Emery Dowell, a member of California's Managed Risk Medical Insurance Board, "This [individual insurance] market is just not a happy place. It's ugly. In order to compete, people have to be extremely cautious about the risks they take. They can't approach the business with much social sensitivity. All they can do is approach it with economic sensitivity on their own behalf" (Wolfson, Orange County Register, 9/2).
The Chicago Tribune this weekend also examined the issues facing the more than 40 million Americans who lack health insurance. According to the Kaiser Family Foundation's Commission on Medicaid and the Uninsured, about one in six non-elderly Americans did not have health coverage in 1999, and 83% of those people are from working families. While Congress grapples with issues that affect those with insurance, including a patients' bill of rights, the Tribune reports that the "vast population of the uninsured still lives in fear of the next unexplained ache" (Lauerman, Chicago Tribune, 9/2). The story is available online.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.