Insurance coverage guaranteed for sick kids, if the timing is right

By Megg Mueller on October 9th, 2010

A measure of President Obama's health care reform act takes effect September 23, and its impact on children's health is significant. Simply put, health insurance companies will no longer be able to refuse coverage to sick kids. Naturally, this has been seen as a huge boon to families who have been turned away after a child falls ill, but like most things, there's two sides to every story.

Some health insurance companies, fearing people would not purchase coverage for kids until after they got sick, decided to stop writing kids-only policies. The companies, including Blue Cross Blue Shield of Florida, said costs would go up for everyone if the policies covering kids weren't purchased until after the kids were already ill. Since the law states they couldn't refuse coverage, the decision was made to just stop selling the policies. Obviously, this hasn't gone over well with consumer advocates and families.

Enter the Health and Human Services Department (HHS), which at the end of July, issued a new ruling -- a stop-gap measure to protect the insurance companies, if you will. According to a recent Bloomberg story, the new ruling allows insurers to enact open-enrollment periods for the kids-only coverage, basically minimizing the risk of them getting swamped by parents trying to insure their sick children after the fact.

The HHS ruling says that to get coverage for your kid, you have to buy in during pre-determined time periods, just like any other health care insurance plan. The HHS hasn't set any guidelines on the enrollment periods, leaving that to state law and the health insurance companies to decide. The new policy will be monitored, the HHS promises, and in case any companies start curtailing coverage too much, it will "issue further guidance on open-enrollment periods if it appears that their use is limiting the access intended under the law," the Bloomberg story notes.

This isn't a bad thing, and if it keeps premiums down it's also a bonus. No one should be denied coverage because they're sick; that's when health insurance is needed the most. This measure of reform falls a little short when the goal was accessible coverage for all, but only during the times insurance companies say are acceptable.

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