Health Care for America Now essentially charged WellPoint with murder today, protesting that the company systematically dropped breast cancer patients from the rolls,
HCAN spokesman Avram Goldstein released this statement, intimating that
criminal prosecutions should be pursued in this case:
“WellPoint is committing
murder by spreadsheet, and it has to stop now.
This is a matter of life and
death, and the executives and board members of WellPoint need to be held to
account to the fullest extent of the law.
WellPoint’s Blue Cross-Blue
Shield companies’ disregard for human life to maximize profits is immoral and
outrageous. The Reuters report shows an unconscionable pattern of denying
needed health care to line the pockets of wealthy executives and shareholders.
Today’s disclosure provides more evidence of why Congress needed to pass national health reform in the first place, and it also shows why we need to curb the extraordinary influence of insurance companies so they don’t interfere with enforcement of the new law. We need the forthcoming federal regulations to shine a light on the insurance companies and hold them accountable for their bad practices.”
Actually, what we needed is
for groups like HCAN to ensure during the debate that practices like this would
truly get outlawed by the Affordable Care Act.
In actuality, insurance
companies, led by WellPoint, lobbied for changes to the restrictions on their
business and a de-fanging of the law. Much like in the current financial reform
debate, they ended up leaving a lot of the regulatory authority open-ended and
at the discretion of regulators, in this case the Health and Human Services
Secretary and the National Association of Insurance Commissioners. Jon Walker laid out how WellPoint successfully removed
independent third-party review of all rescission cases.
Reuters reports that
WellPoint is under federal investigation for singling out breast cancer
patients and dropping their coverage “based on either erroneous or flimsy
information.” They also report that language in the House bill would have
protected these women, but it was removed in the Senate version of the bill
because “lobbyists for WellPoint and other top insurance companies successfully
fought proposed provisions of the legislation.”
Max Baucus, head of the
Senate Finance Committee, credits former WellPoint VP Liz Fowler with writing
the “blueuprint” of the bill, and her name appears as “author” on the bill PDF
released by the committee [...]
As you can see, the Senate
bill does not mandate either independent third party review or the continuation
of coverage while the review is taking place. Theoretically it’s possible for
the Secretary of HHS to require a similar independent third party review
framework for rescission, but unlike the House bill, the Senate bill which
ultimately passed does not require her to do so — something WellPoint actively
lobbied for.
The White House might argue
that rescission is a thing of the past because the law guarantees issue of
health insurance, and with risk adjustment insurers will have an incentive to
even pick up sick patients. However, in reality the risk adjustment mechanism
is far smaller than the liability of sick patients, and insurers will
undoubtedly work hard to avoid as many patients with pre-existing conditions as
possible.
We now have a whodunit, where we have to ask who in the Senate pushed to eliminate the toughest regulatory restrictions from insurance companies who obviously have no compunction against systematically denying coverage to breast cancer patients.
Obviously Liz Fowler, the former WellPoint VP,
is a good place to start. So
far, nobody privy to those discussions has been willing to say on the record
that Fowler is culpable. But the insurance industry, already hated in the
country, has now committed what even cautious groups like HCAN call murder.
Covering for the culprit here is tantamount to being an accessory to the crime.
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