Tuesday, March 30, 2010

Mitch McConnell Versus Barack Obama In A Pre-Existing Condition Smackdown

You should read the whole thing to understand the confusion about this issue.  I'm pulling out just a few critical bits.  It seems that Obama didn't have time to read the whole bill, but that didn't stop him from promising benefits that weren't actually in it.

First, the AP, Kaiser Health News and Mitch McConnell are correct.  Folks reassured by an appeal to authority will note that the AP has quotes from two Democrats supporting their interpretation:

Under the new law, insurance companies still would be able to refuse new coverage to children because of a pre-existing medical problem, said Karen Lightfoot, spokeswoman for the House Energy and Commerce Committee, one of the main congressional panels that wrote the bill Obama signed into law Tuesday.

...Full protection for children would come in 2014, said Kate Cyrul, a spokeswoman for the Senate Health, Education, Labor and Pensions Committee, another panel that authored the legislation. That's the same year when insurance companies could no longer deny coverage to any person on account of health problems.

Folks who distrust authority and want to see for themselves will be fascinated by the supplement to this post, where we dig through the text of various bills to piece the arguments together.


Put simply, insurers deny coverage to people; they exclude coverage of conditions.

A pre-existing condition can affect your health insurance coverage. If you are applying for insurance, some health insurance companies may accept you conditionally by providing a pre-existing condition exclusion period.

Although the health plan has accepted you and you are paying your monthly premiums, you may not have coverage for any care or services related to your pre-existing condition. Depending on the policy and your state’s insurance regulations, this exclusion period can range from six to 18 months.

So previously a health insurer could simply refuse to enroll a particular applicant or they could accept an applicant subject to restrictions on coverage of the applicant (or in this case, an applicant's child).  If we are talking about a group plan offered by an employer, turning the applicant down is not an option; HIPAA regulated the waiting periods during which a pre-existing condition exclusion could be applied, and this new bill reduces those waiting periods to zero for children (after it takes effect in September 2010).


I think that Obama, by merrily conflating "pre-existing condition exclusion" with denial of coverage, is trying to make domestic policy by gaffe the same way he has tried to make foreign policy by gaffe.

Posted via email from The Blue Pelican

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