Commentary: Insurance industry still holds health care cards

Main Street wonders how exactly health care reform will work.
Main Street wonders how exactly health care reform will work. Dean Rutz/Seattle Times/MCT

So, what's this baloney about a "government takeover" of health care?

Seems like the insurance companies still call the shots. As some provisions of the federal health care plan took effect Thursday, insurers were cherry-picking the regulations.

That congressionally mandated requirement that insurers cover parents' adult offspring up to age 26 on the family health plan? The industry is OK with that because 20-somethings seldom see the doctor. Many companies complied months ago.

But when it came to the requirement that all minor children be eligible for coverage regardless of pre-existing conditions — oh, no, no, no.

The insurance companies aren't keen on that one at all. Certainly they have no choice but to comply with the rule when millions of Americans renew their family health plans through their employers in the months ahead. Same for family policies that people buy on their own.

Wouldn't want to give up those markets.

But some insurance companies this week did refuse to admit new enrollees to child-only health plans in states where insurers face no penalty for doing so.

That includes all four of the companies that were offering the policies in Kansas: Humana, Aetna, Coventry, and Blue Cross and Blue Shield of Kansas.

Meanwhile, in Missouri, Blue Cross and Blue Shield of Kansas City was the only company to continue offering new plans on Thursday, after Coventry and Anthem Blue Cross and Blue Shield pulled out.

Even then, the spokeswoman for Blue Cross and Blue Shield of KC was careful to say her company will continue selling the policies "at this time." She couldn't promise that things won't change.

What do the bureaucrats have to say for themselves?

"As state regulators, we don't have the authority to tell the companies to offer these policies," said Bob Hanson, spokesman for the Kansas Department of Insurance.

I got a similar response from Missouri's regulators, while in D.C. the feds fretted and clucked.

The reason companies say they're no longer offering child-only policies is their fear of the unknown costs. They say parents might wait to buy coverage for a particular child until some horrible, costly illness is diagnosed, then saddle the insurer with enormous medical costs.

"That's a high-loss position," said Brent Butler, a spokesman for the insurance industry in Missouri.

The problem with that argument? Neither the insurers nor the regulators can tell you how many people buy child-only policies in the first place. Even the industry admits it's a tiny market, but crucial for a lot of folks nonetheless.

Some people who buy child-only plans don't have access to a family plan at work. Or they do but can't afford those premiums, which can be higher than child-only plans, which run less than $100 a month.

People on Medicare raising grandchildren also buy the coverage.

And now, unless they already have a policy in place, these people won't have access to that insurance in most states.

Of course, some critics will blame the government. Probably what the industry is hoping for, if you ask me, as Republicans promise to repeal the health care bill.

Only with this move, it's the insurers who come off looking the worst.

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