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HHS Hits Preexisting Condition Limits

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An insurer could charge high premiums, deny coverage, or set a restriction such as denying any respiratory disease coverage to a person with hay fever, according to a new report from the U.S. Department of Health and Human Services.

HHS also claims some insurance companies respond to an expensive condition such as cancer by opening a thorough review of the patient’s health insurance application. If a company discovers that any medical condition, regardless of how minor, was not reported on the application, it could rescind coverage retroactively for the patient and possibly all members of the patient’s family, according to the report, “Coverage Denied: How the Current Health Insurance System Leaves Millions Behind.”

At least one company encouraged employees to revoke sick people’s health coverage through rescissions, the report said without naming the company

Current health care reform proposals before Congress include a plan to ban insurers from refusing coverage based on a person’s medical history or health risk, HHS notes.

At the same time, a key insurance industry player, America’s Health Insurance Plans, Washington, appears committed to seeing enactment of health reform legislation through even as its members endure withering criticism from the public as well as the Obama administration and the House Democratic leadership.

In a statement last week, AHIP president and CEO Karen Ignagni defended the industry, saying, “Health plans last year proposed health insurance reform to make sure that no one is denied coverage because of a pre-existing condition.

“Our proposal includes new consumer protections and market rules to guarantee coverage for pre-existing conditions, discontinue basing premiums on a person’s health status or gender, and get everyone covered through a personal coverage requirement,” she said.