Administration Applauded for Holding Insurance Companies Accountable for Covering Children with Pre-Existing Conditions

Washington, D.C.—Families USA, the national organization for health care consumers, issued the following statement today:

“Families USA, the national organization for health consumers, commends Secretary of Health and Human Services Kathleen Sebelius for her recent letter to the National Association of Insurance Commissioners (NAIC), which firmly holds insurers accountable for covering children with pre-existing conditions. At the same time, the letter articulates a reasonable position that gives health insurers the needed flexibility to protect against adverse risk selection. Going forward, there is no excuse for insurers to withdraw from the child-only plan market and abandon children who are counting on access to coverage.

“The Affordable Care Act will make coverage more affordable and accessible for millions of Americans when fully implemented in 2014. The new law provides important interim relief to many Americans who need it the most, including children who have pre-existing conditions. The Affordable Care Act set an important principle for immediate reform: Children with pre-existing conditions cannot be treated differently than other children with respect to their right to enroll in plans and receive immediate coverage for their health conditions. Unfortunately, some insurers have threatened to stop offering ‘child-only’ health insurance plans, reversing their promise to ensure that denials of coverage based on pre-existing conditions are ‘a thing of the past.’

“The administration has taken the right step forward by holding firm to the principle that all children should have equal access to coverage regardless of their health status. In the letter to NAIC, Secretary Sebelius confirms that states can establish open enrollment periods to limit when parents can sign their children up for coverage, but that plans cannot shut out sick children while enrolling only healthy children the rest of the year.

“Health plans already have the tools they need to minimize their risks. Insurers may create open enrollment periods and adjust rates based on health status, as permitted by state law.
 
“There are important tasks left for state legislators and regulators to protect children with pre-existing conditions. First, states should ensure that open enrollment periods are well-advertised and of sufficient duration that children will be able to enroll. Second, states should take additional steps to make sure all children have access to a health plan. They can do this by opening their children's health insurance programs to all kids, allowing families to buy the coverage at full cost. Further, they can require that insurers who do business in their states will sell child-only policies. And states should make sure that employers do not encourage workers to enroll children in child-only policies instead of employer-sponsored insurance.”

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Families USA is the national organization for health care consumers. It is nonprofit and nonpartisan and advocates for high-quality, affordable health care for all Americans.

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202-628-3030 · Email: info@familiesusa.org · www.familiesusa.org