The New Health Dialogue

Remember when Secretary Sebelius talked last week about the prospect of "hand to hand" combat with some health insurers over implementation of the new health reform law?  The same day she wrote WellPoint calling them out on rescissions -- canceling policies of women who get breast cancer? WellPoint announced this week that it would end the harmful practice of rescissions starting in May, while insurers all across the land will have to stop the practice under health reform just a few months from now.

Rescissions occur when an insurer drops a patient who becomes seriously ill, and justifies the coverage cancellation by accusing the patient of concealing a previous health condition. The reason rescissions provoke so much anger and outcry is because the “concealed health conditions” are often nothing more than a flimsy pretext. They can be anything from a previous case of acne (justification for dropping a woman who was diagnosed with breast cancer days before a double mastectomy) to an unrelated problem like a CT scan showing gallstones (for a patient who was later diagnosed with lymphoma and dropped).

Following a Reuters article that revealed WellPoint used a specific computer algorithm to target and revoke coverage for women with breast cancer, Sebelius sent a letter last week to the insurer asking them to end rescissions immediately. She called the practice deplorable, and pointed out that would soon be illegal under the new health reform law. Earlier this week, House Democrats also sent a letter to major insurance executives (including WellPoint), asking them to end rescissions before the federal deadline in September.

WellPoint is not alone in the practice of rescissions, but they are the first we know of to say they will end the practice before the deadline. At a hearing last summer, several major insurance executives testifying before the House Energy and Commerce subcommittee on Oversight and Investigations told Congress they had no intention of ending the practice of rescissions anytime soon. (An additional devastating example -- another insurer specifically targeted patients diagnosed with HIV for rescissions.) WellPoint CEO Angela Braly said in Politico today,

Our goal is to make reform work for our members and for the country…There have been a lot of misrepresentations and inaccuracies in recent days that have caused confusion among our members and among the public generally about our policies in this area.  We think today’s announcement will go a long way toward bringing greater clarity.

The new health reform law does not prohibit dropping coverage of people who have committed some form of insurance fraud or abuse. That's a different situation. But the law makes it harder for insurers to drop clients who got insured to protect themselves in the case of illness -- and then lost their coverage precisely because they got sick. Health reform implementation is going to be a bumpy road, but we’re glad that in this particular instance, at this particular moment, the path got a bit smoother for some patients.