HHS Issues Clarification on Children’s Insurance Coverage in Reform Law
On Monday, the Obama administration issued a clarification of a provision in the new health reform law, notifying health insurers that as of this year they are prohibited from denying coverage to children with pre-existing conditions, the AP/Philadelphia Inquirer reports.
HHS Secretary Kathleen Sebelius issued the clarification in a letter to Karen Ignagni, president of America's Health Insurance Plans (Alonso-Zaldivar, AP/Philadelphia Inquirer, 3/30).
According to Reuters, the administration took action after a recent media report examined how some insurers were attempting to take advantage of a loophole in the new law that would enable them to ignore the coverage requirement until 2014 (Holland, Reuters, 3/29).
According to the AP/Inquirer, the provision's "fine print" is "less than clear" on whether the requirement takes effect this year or in 2014, when a broader ban on denying coverage for people with pre-existing conditions takes effect (AP/Philadelphia Inquirer, 3/30).
In the letter, Sebelius wrote, "To ensure that there is no ambiguity on this point, I am preparing to issue regulations in the weeks ahead ensuring that the term 'pre-existing condition exclusion' applies to both a child's access to a plan and to his or her benefits once he or she is in the plan" (Wayne, CQ Today, 3/29). She noted that the regulations would make clear that by September "children with pre-existing conditions may not be denied access to their parents' health insurance plans," adding, "Now is not the time to search for non-existent loopholes that preserve a broken system" (Reuters, 3/29).
Insurance Industry Response
In a letter to Sebelius, Ignagni wrote that AHIP's members would accept the clarification of the new law and "fully comply" with it. She added, "Health plans recognize the significant hardship that a family faces when they are unable to obtain coverage for a child with a pre-existing condition" and that members would be ready to work with HHS to implement the new regulations (AP/San Francisco Chronicle, 3/30).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.