SUPREME COURT: Allows Cap on AIDS-Related Illnesses
The U.S. Supreme Court yesterday let stand a ruling that allowed an insurance company to provide less coverage for AIDS-related illnesses than for other conditions under the same policy, the New York Times reports. The high court, without comment, refused to hear the appeal brought by two HIV-positive Chicago men who claimed that their insurance company's policies violate the Americans with Disabilities Act (New York Times, 1/11). The two policies in question were issued by Mutual of Omaha. One policy set a $25,000 lifetime coverage limit for AIDS-related illnesses and the other contained a $100,000 cap, while both allowed a $1 million cap for other illnesses. Attorneys for Mutual of Omaha argued that the insurance company had not discriminated because it offered the men the same coverage offered to other customers. In 1998, a federal judge in Chicago ruled in favor of the two men, but the 7th U.S. Circuit Court of Appeals reversed that ruling (Asseo, AP/Nando Times, 1/10). At the time, the appeals court said the ADA guarantees access to insurance but does not regulate the content of coverage (New York Times, 1/11). In addition, the appeals court said that most health insurance policies contain coverage caps and that ruling for the two men "would ban coverage caps for diseases classified as disabilities but allow limits on coverage for other illnesses, such as heart disease (AP/Nando Times, 1/10).
Lawyers for the two men have previously expressed concern that the appellate court's ruling might set a trend for other insurers to set similar limits (Jordan, Omaha World-Herald, 1/11). Heather Sawyer, a lawyer at the Lambda Legal Defense and Education Fund of Chicago, said, "We are disappointed that the court will not provide much-needed guidance to the lower courts on this life-and-death issue" (Denniston, Baltimore Sun, 1/11). However, she noted that Monday's ruling "doesn't mean that this is now a green light for AIDS caps and that any insurance can initiate an AIDS cap." Sawyer said the court did not want to use this case as the benchmark to determine if the disabilities act protects against insurance limits (Omaha World-Herald, 1/11). In a written statement released Monday, Mutual of Omaha said, "This is an important decision. The decision means that the ADA does not require every business to modify every product to accommodate every disability" (Baltimore Sun, 1/11).