Citing Pre-Existing Conditions, Large Health Insurers Denied Coverage to 651,000 Applicants in Individual Market

The four largest private health insurers denied policies to one out of every seven applicants for individual policies in 2007-2009, based on pre-existing medical conditions, according to a report by the Wall Street Journal.

Findings released by Reps. Henry Waxman (D-Calif) and Bart Stupak (D-Mich.) showed Aetna, Humana, UnitedHealth Group and WellPoint denied coverage to more than 651,000 people due to pre-existing conditions over the three-year period. In the same time period, the insurers refused to pay 212,800 medical claims for people who had individual policies, citing preexisting conditions evident before the policies were bought.

The lawmakers said pregnant women, fathers-to-be and people attempting to adopt children are generally unable to buy policies on the individual insurance market.

America's Health Insurance Plans, the health insurers' trade group, said without the healthcare reform law's universal mandate to buy coverage, due to start in 2014, insurers need to deny coverage for pre-existing conditions in order to discourage people from buying a policy only after they get sick. If people were allowed to do this now, AHIP noted, it would increase costs for all consumers.

WellPoint and several other major insurers recently stopped selling new policies for children, citing the healthcare reform law's requirement to start accepting children with preexisting medical conditions. The reform law would begin a similar requirement for adults when the mandate to buy insurance goes into effect in 2014. Until then, the federal government is providing funds for state to set up risk pools to accept people with pre-existing conditions, but several states have refused to do so, citing the cost.

Read the Wall Street Journal report on health insurance.

Read more coverage on pre-existing conditions.

-Three Insurers to Stop Offering New Children's Policies, Citing Reform Law

-Arizona Latest State Refusing to Create Risk Pool for Pre-existing Conditions

-Hospitals and Insurers Oppose Reduced Penalties for Uninsured


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