While picking up my oldest child from preschool last week, I tuned the radio station to NPR and caught only a tiny segment of the Diane Rehm Show which that day featured Health and Human Services Secretary Kathleen Sebelius. I was dying to listen to the whole interview (knowing she’d be talking about the 1-year anniversary of Obamacare) but had to exit the car to get the kid (I was tempted to just scream my child’s name and hope he could dodge the many mini-vans…but I did the right thing and fetched him in person). By the time I made it back to the car, I’d forgotten about the interview.
Luckily, Forbes blogger Merrill Matthews—a resident scholar at the Institute for Policy Innovation in Dallas, Texas—has provided kid-fetching moms a revealing synopsis of the Sibelius’s radio interview.
Matthew’s points out that Sebelius claimed during the interview that the opposition has been delivering “lots of misinformation” about the legislation. Fair enough…we expect such rhetoric from the HHS Secretary. But it’s good to know there are bloggers like Matthews to point out that she’s really the one disseminating the misinformation. From Matthews:
Sebelius used the example of a hypothetical female small business owner with a child. The young mother “and her employees can be medically underwritten, so a company can say we’re not going to cover your employee with a heart attack,” and then claims, “there are not many laws around the small group market.”
In fact, states have been heavily involved in regulating small group health insurance for decades. The primary federal law is the Health Insurance Portability and Accountability Act (HIPAA), sponsored by Sebelius’ fellow Kansan, former Republican Senator Nancy Kassebaum, and passed in 1996 by a Republican-led House and Senate.
Under HIPAA, insurers selling in a state’s small group market MUST accept all employees in the group. They cannot reject one employee, as the secretary asserts, because of a heart attack or any other medical condition. The Illinois Department of Insurance nicely summarizes HIPAA requirements in one of its “Insurance Facts” publication: “An insurer cannot refuse to sell to small employers (if the insurer sells small group coverage) and must cover all employees and dependents, regardless of health conditions, who are eligible under a small employer’s plan.”
That’s federal law. Since Sebelius was the Kansas insurance commissioner when HIPAA passed, you’d think she would know that.
Yeah…you’d thing, right? But to “know that” would certainly put a hole in the argument. Matthews then notices another glaring example of what only can be (and these are my terms…given her clear understanding of the issues) LIES from Sebelius:
Sebelius continues: “She also is a woman. So women in the insurance market could be given extraordinarily higher rates because they might get pregnant at some point in their lives, or the insurance company would just refuse to cover anyone who was a woman because of a potential pregnancy.”
This statement is stunningly wrong. Federal law absolutely prohibits excluding employees within a group, including for being female. And if any health insurer refused to cover all the women in a group because one might become pregnant, the state insurance commissioner would run the insurer out of town on a rail. Again turning to the Illinois DOI, “Pregnancy cannot be denied as a preexisting condition by an employer’s insurer.”
Oh, but Sebelius isn’t done with this pregnant woman. She continues this dialogue suggesting additional problems are in store for this fictional woman after she delivers her baby:
Sebelius then goes on to say the business owner’s hypothetical child was born with a heart defect, but the problem was fixed and the child is now five years old and healthy. “That’s a so-called pre-existing health condition. That child for the rest of his or her life under the old regime … could be discriminated against by insurance companies at every step along the way. Insurance companies could deny coverage to that child. When her son became an adult they could say we don’t want you ever in an insurance pool, or we’re going to charge you three or four times as much as anybody else. That’s now illegal in this country thanks to the Affordable Care Act.”
But as the Illinois DOI points out, “[P]reexisting conditions cannot be applied to newborns, adopted children under age 18 or a child under age 18 placed for adoption as long as the child becomes covered under the health plan within 30 days of birth, adoption or placement for adoption” (if done within 63 days).
If that business owner has what’s known as “HIPAA-qualified” coverage, meaning the coverage meets the requirements of the HIPAA legislation-and the large majority of employer-provided group coverage does-the child would have health insurance options for the rest of his life.
It’s too bad Diane Rehm was unable to muster enough journalistic integrity to actually prepare for her shows before her guest appeared. A little research would have shown Sebelius’ hot air. But then, Rehm is part of a media machine supportive of Obamacare.
Thank goodness for moms like me, I have bloggers like Merrill Matthews to set the record straight.