The Real Health Care Coverage Threat

30 Jul

I’ve spent a lot of time talking about unwarranted fears over the past week in an attempt to ameliorate the concerns of many who oppose health reform based on inaccurate information they believe to be true. By contrast, I’m not out to convince opponents of reform to change sides, provided they have their facts straight.

The propaganda keeps coming though. Seriously, these folks are relentless. Now, the fear mongering is targeting the elderly. The–honestly very scary if it were true–misinformation: you’re going to lose your Medicare coverage. Well, not completely, but a lot of your benefits are going bye-bye. All of this is patently false, but it’s having a powerful effect on the country’s senior citizens. This is why the New York Times and Slate both have articles examining the issue in which the elderly express their concerns that proposed health reform legislation is putting the nation on a slippery slope towards euthanasia of seniors. It’s both morbid and ridiculous.

What’s flying under the radar, however, is the current–and very real–threat to health care coverage: recission. You may not have heard of this word before, but you may likely know someone to whom it has happened. Recission happens in the wake of filing an insurance claim, when the insurance company denies you your benefits–which ordinarily would be covered–by canceling your policy. The basis for the cancellation goes something like this: You file an expensive claim. The insurance company doesn’t want to pay it (i.e., lose money). They find something technically wrong with your paperwork that “justifies” cancellation of your policy.

Now, there are certainly cases where recission is a necessary protection for the insurer. For example, if you failed to disclose prior treatment for breast cancer, and you later seek coverage when you suffer a recurrence, that’s tantamount to fraud on your part. If, on the other hand, you filled the forms out incorrectly, or failed to disclose something you didn’t know about or that turns out to be completely unrelated to the current claim you’re filing, and the insurer cancels your policy? Well, that makes for something you could grow a nice crop of tomatoes in.

This kind of thing happens all too often, and is mentioned in Michael Moore’s notorious film Sicko as well as two articles appearing this week from Timothy Noah and Jonathan Weber. As reform moves forward, there’s mention of outlawing coverage denial on the basis of pre-existing conditions, and that’s important both for expanding coverage and severing one of the links on which recission is based: If there are no “pre-existing” exclusions, the accuracy of your health history should not be grounds for future claim denials. Still, if consumer protections are such a big part of reform, shouldn’t something more be done to prevent the practice of unjustified recission?

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Posted by on July 30, 2009 in Uncategorized


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