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You Can Insure Just Your Child ... for a Price
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Sorry, kid, no individual insurance policy for you. Credit: Getty Images
"Yeeees," he said as he rubbed his hands together. "You can have your precious child-only health insurance policy back. And all it will cost you is ... higher premiums!"
From out of nowhere, there was sudden, loud and ominous blast of organ music. The man seemed to erupt in flames, and before the young mother could gather her wits, the mysterious stranger vanished as quickly as he had appeared. All that remained was a cloud of smoke that smelled faintly of brimstone.
To be fair and balanced, insurance companies are not the devil. Or even his minions. That's just an incredibly popular (and probably only partially true) legend.
Another is that the Obama administration made a Faustian bargain with insurance companies. That legend, however, is based on actual events.
Earlier this year, health insurance companies dropped child-only insurance policies because the kids just didn't bring in enough money. Administration officials feared sick children may go uncovered and untreated, so they struck a deal.
If companies agreed to restore child-only policies, in return, the administration would allow companies to jack up their premiums so they can turn a profit. That is, assuming individual state laws permit it.
But not all the companies are playing ball.
"Unfortunately, some insurers have decided to stop writing new business in the child-only insurance market, reneging on a previous commitment made in a March letter to 'make pre-existing condition exclusions a thing of the past,' " Secretary of Health and Human Services Kathleen Sebelius says in statement quoted by The New York Times.
Insurers argue they're not greedy devils, just economic realists. They won't have the resources to help anyone if they don't turn a profit. In other words, they can't help the sick unless the majority of the people paying premiums are healthy.
They told administration officials child-only policy are fiscal disasters waiting to happen because, under health care reforms, families can buy insurance for their children at the last minute. While that may make sense from a humanitarian standpoint, insurance executives argued it hampered their ability to do the greatest good for the greatest number of people.
All this may be moot in 2014.
Unless Republicans win enough seats in Congress next month to make good on their plans to scuttle health care reform, all Americans will be required to have health insurance by 2014. Insurance companies won't be able to turn either adults or children away because of pre-existing conditions.
The Times reports the Obama administration and insurance companies have been locking horns for months. Administration officials want companies to cover children with cancer, autism, heart defects and other conditions.
Yet, most parents are lucky if they can find insurance that covers braces.
In a letter quoted by The Times, Sebelius calls the continued reluctance of some insurance companies to offer child-only policies "extremely disappointing."
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ReaderComments (Page 1 of 2)
10-18-2010 @ 8:00AM
Chris said...And this article is paid for and endorsed by the Republican party, what ever happened to a good article that gives all the facts.
Reply
10-18-2010 @ 8:40AM
steve said...Can you prove that?
10-18-2010 @ 11:18AM
Guillermina said...thanx to osama insurance will be prohibitive. We have the best health care in the world, and NO ONE is refused health care regardless of ability to pay. IT'S THE LAW
10-18-2010 @ 1:17PM
Mike said...Typical Liberal Democrat.....don't let the FACTS get in the way of good Democrat politics......just because you are too STUPID to understand the facts does not mean they are not there....The truth is plain and simple, if these companies can not remain profitable then there is NO INSURANCE FOR ANYONE, then the government takes it over and we all WAIT IN LINE, except for the very wealthy (most are Liberals and corrupt Dem politicians), and of course politicians will have there own doctors. Wake the F... UP, Obama and his pals want CONTROL of ALL aspects of our lives, then we have only them to go to. Let's see, when has it ever worked where everyone is beholden to the GOVERNMENT (NEVER!). The vast majority of people in this country are truly well intentioned, decent, honest people (Yes, even you Liberals). The more we are in control of our lives, and MONEY, the better off we all are, plain and simple. When did you Liberals lose sight of that, we all want the same thing........FREEDOM!
10-18-2010 @ 8:43AM
Tony said...To be fair and balanced, THE INSURANCE COMPANIES ARE THE DEVIL!!!.. Assurant Health (Time Insurance) has raised my rates 494% in 5 years. What once was an affordable policy is now far more than my mortgage. Can't blame this on Obama's health care reform. It has been going on since 4 years beffore the health care bill was enacted. The insurance companies need to be brought before Congress.
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10-18-2010 @ 3:22PM
matt said...Well, Tony, being an Insurance Broker who also offers Assurant Health, if your health premiums went up that much in the past 5 years it was probably due to the fact that YOUR NOT HEALTHY or YOUR OLD? Premiums on all insurance plans increase each year 5-10% simply based on your states new mandatory coverage requirement set forth by your states elected officials and due to the fact that you are getting older every year. If your premiums went up that much why didn't you just LOOK FOR A DIFFERENT POLICY, DUMBA$$! Thats the great thing about living in a country that allows you to purchase your own health insurance. If you want to bitch about your insurance premiums, DONT BUY HEALTH INSURANCE. Just put that money in the bank each month and see if what you got in there when you have your next heart attack is enough to cover the bill. I bet your the kind of person who cry's when you do use your health insurance and you have to shell out $1000 of a $80,000 bill or the type that sues a doctor for $1.8 MIll because they made a small mistake while trying to save your life. You never hear people say "thank God I had insurance when I had my stroke that would have cost me a fortune without insurance but instead I only paid a small percentage of the bill." Tony perhaps your money would be better off invested in your education, rather than spouting off ignorant statement simply based on your stupid opinion. The Government was not created to tell me I have to buy health insurance or to force a company to make poor risk decisions. So if you want to complain about your health premium either stop paying for it and insure your self, or give away all your possessions and go on welfare. I'm sure the federal government will take GREAT care of you.
10-18-2010 @ 11:47AM
Sarah Mom said...Wow Matt! You say "being unhealthy" or "old" in your comments as if
either of those things were within anyone's realm of control. I don't
believe that someone like you should be representing the views of any
insurance company if they (including your employer) seeks to defend
their image to the American public. All insurance companies should be converted to NPOs.
10-18-2010 @ 11:59AM
AJ said...Matt - It would appear that you have some anger management issues! If you had even read the entire page, you would have seen a second post where Tony states that the premiums are more than all of his medical expanses for 8 years. Doesn't sound like he (or his family) is sickly. I think you are the one missing an education. Some states have very little competition in the health insurance realm and rates are only increased if the entire class of insured is subject to the same premium increase. 5 - 10% increase per year? You aren't living in this world. I don't believe that you are an insurance broker. More probably, you are a teenage poser or a welfare recipient (you seem to know something about welfare, unlike insurance).
10-18-2010 @ 1:42PM
KATHY said...Wow - Matt, chill out dude. We will all get old and unhealthy before we die. Does this mean the insurance companies can bend us over a chair and buttslam us?
The insurance companies make record profits and allow people to die by denying them coverage. I have a friend who died because he could not get a liver transplant. The insurance company said it was elective insurance and not necessary. The transplant would have cost the company around half a million. Needless to say the family sued and won 15 million. Which would have cost the insurance company less and saved a life?
I don't believe you are an agent at all. I think you are a fraud and a liar.
10-18-2010 @ 8:47AM
Larry Meredith said...This "healthcare reform" monster has been devised by idiots who don't have a clue of what it takes to run a business and be profitable. The first thing to go will be the agents in the field, (approx 565,000 out of work), because insurer's won't be able to pay the claims AND commissions at the same time, unless they raise premiums to cover the horrendous addtional costs of insuring anyone, pre-existing or not. Most agents make their lving on commmissions, not big fat salaries paid by major corporations. Ultimately, because of the stupidity of this program, insurance companies have said no child only policies, this also holds true for their incredibly stupid, MLR, (medical loss ratio), of 80%, and leaves the insurer's with only a 20% gross profit to pay for all of the overhead of admionistration, underwriting, claims service, customer service, utilitiy expenses, etc, etc, etc, etc.! It is actuarily and mathematically impossible. These morons are driving this country into bankruptcy to serve their own agenda and make government takeover their prime goal. If the people of this country don't WAKE UP to what's going on around them, this is exactly what's going to happen with this narrcicistic, socialism driven moron they call our president, and his entourage of like minded idiots. Don't believe me about the math?? Ask a CPA, any CPA, and they'll tell you the same thing. Servioce will go out the window, millions more will go on the unemployment payroll lines, claims will be delayed for more than 6 months, and on, and on, and on. Does this contry need health care reform?? Absolutely, but not this piece of garbage. Not all states, ans insurance cariers are anywhere near as bad as they elstupido's in Washington want you to believe. Stop or put a ceiling on law suits, get the insurer's who do create a disservice to members, like cancelling their policy because their expenses are to high to get comliant or get out of the business. There are lots of ways to curb costs, and make the system better, but not the way they have laid it out. And what has "adding" the 3% sales tax to the sale of your home got to do with health care??? Yep, that's part of the new "LAW." WAKE UP PEOPLE, GET INVOLVED, GET ENGAGED, AND PAY ATTENTION, HYOU'RE GETTING SCREWED. How about Obama traveling all over the country campaigning for all the democrats to be relected, ON OUR DIME?? Yes, that taxpayers are paying for this entire campign tour of his, instead of hin being back in Washington taking care of business. Think about it. They, the dummycrats, are running scared, have pulled out all the stops to do what?? MAINTAIN CONTROL OF US! THAT, MY DEAR AMERICANS, IS THE BOTTOM LINE!
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10-18-2010 @ 9:11AM
opinionated said...Amen Brother - why is there no press on the hundreds of insurance companies driven out of business - all the health insurance employees out of work - all the agents cut out - how insurance companies may be forced to take a very ill child on a parents NEW policy - but to survive can - and will - rate the child AND their parents up 500% EACH - it is in the Health Bill that they can go up to 500%........a little government sleight of hand - just go to any auto insurance company with a total wrecked car and 3 DUI's - demand they fix the wrecked car - give you the same lower premiums as the careful driver with a safe car and - oh no - the company cannot take into account the 3 DUI's - see how far you get - that is EXACTLY what the government is demanding the Health insurance companies do - that is how they are driving private enterprise out of existence
10-18-2010 @ 10:45AM
Hooseerfan said...Larry is exactly right, and he is almost repeating me verbatim. We have never met or read anything each other has written but I can see he is in the business and understands the misconception plus lack of understanding how insurance works by many of the citizens along with many of the presidential Admn. Also the toher reply about job losses is something i have tried to expose many times in some of my postings.
10-18-2010 @ 11:28AM
ray said...you are not very smart,insurance companys in this country pay less than 30% of the money they take in for the claims of there insured.to make it simple for you they have a 70% profit margin.I dont really care if that goes down to 10%,if they cant do things right they should be forced out and too hell with there stockholders.
10-18-2010 @ 2:33PM
empiresentry said...Wow 70% profit. I need to buy that stock. What bogus numbers. Ummm, the stock is lousy. Perhaps its the 3% profit margin and all the donations paid to the democartic national party. They said they would force everyone to buy insurance but later told the insurance companies it would be a gov insurance. Two faced as usual. Access to insurance does not equal access to health care.
10-18-2010 @ 9:18AM
Miss Marple said...Insurance companies are nothing more than legalized thief's. They make big promises, but try hard not to keep them. I used to be a benefits rep for a company that employed 4,000 people at a great cost to the company as employees did not have to pay for coverage. The insurance company routinely denied part of the claim for various reasons. It would take just one call from me and they admitted the claim had not been paid correctly and immediately paid the claim in full. There were very few instances when there was a legitiment reason for not paying the claim. I think the insurance company did this on purpose thibking most folks would not take the trouble to contact them. I was able to get over $700.00 back for a woman who did not contact me. I heard about it from her friend and sought her out. She thought she owed the money.
Auto insurance companies are the biggest theifs of all.
Reply
10-18-2010 @ 9:50AM
Mark Battistone said...Hey Tony,
I'm a insurance agent. Did you ever think about raising your deductible to offset rate increases. And Assurant up until June of this yr, had guaranteed rates up to 3 yrs.
Don't get mad at Assurant,I'd be talking to my agent!
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10-18-2010 @ 10:01AM
Tony said...Yes, I raised my deductible to $3500.00. Assurant IS the bad guy here. I've taken my complaint to the state. I really think that I would be better off self insuring. One year of premiums is more than my entire medical expenses over the past 8 years.
10-18-2010 @ 9:58AM
cia said...Yes what a terrible thing the Obama Admin. is doing. Imagine actually forcing the insurance companies to cover children with cancer, heart disease, birth defects, autism, etc. so they can see a doctor and their families don't have to give up their houses and declare bankruptcy just to get their child treated. I agree that people need to WAKE UP. They need to vote democaratic before the Republicans and Big Business take all the wealth in this country and turn us into serfs.
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10-18-2010 @ 9:59AM
Cheryl said...Just a couple comments ...
This issues with healthcare are huge and will not likely be solved easily. Number 1, pre-existing conditions will no longer be denied. So the insurance company says - okay we will right your policy, let's rate your risk (the likelihood you will have a claim), here is the amount of premium ... clunk, that is you fainting when you see the cost of the premium. Just because the government now says you cannot deny pre-existing conditions does not mean people will be able to afford it. Let's say your premium comes back at $5,000 a month, unless you are getting treatment / medications in excess of $5,000 a month - why would you pay that?
Then in 2014, you will be required to carry that coverage. What if you can't afford to pay that? I think most people that can afford the high premiums aren't sick and work full time with likely group health benefits (which is why it appears they could afford it).
Lastly anyone who knows about any insurance knows that you pay a premium for the risk (what might happen) ... it is a business like anything else. Do some companies make bad decisions - no doubt. But there are are thousands and thousands of claims paid each day in this country without issue, we just don't hear about those.
There is no easier answer to this, but the government should stop accusing any and all private businesses that employee millions of people as being the villians.
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10-18-2010 @ 10:07AM
BARGAINBAYUSA said...WHAT EVER HAPPENED TO GOOD DECENT DOCTORS THAT DIDN'T CHARGE YOU $150.00 OFFICE VISIT CHARGE ??? * & THEN THEY WANT TO GIVE YOU EVERY TYPE OF TEST IN THE WORLD INCLUDING MRI's WHICH YOU HAVE TO MORTGAGE YOUR HOUSE TO PAY THE BILLS JUST TO HEAR YOUR DOCTOR SAY HE REALLY DIDN'T KNOW WHAT WAS WRONG WITH YOU & THERE WILL HAVE TO BE MORE TEST BUT HE WONT GIVE YOU ANYTHING TO EASE THE PAIN OR MEDICATION TO FIGHT THE INFECTION & ON THOSE RARE OCCASIONS THAT HE WILL GIVE YOU A SCRIPT FOR SOMETHING IT IS FOR A WEEKS SUPPLY & IT COST $300.00 & COULD EASILY GIVE YOU A STROKE OR HEART ATTACK OR LIVER DAMAGE OR KIDNEY FAILURE * YOU HEAR THE DISCLAIMERS ON TV ALL THE TIME "IF YOU HAVE A STROKE OR HEART ATTACK CALL YOUR DOCTOR IMMEDIATELY" *****
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SHAME ON THE ENTIRE MEDICAL PROFESSIONAL HOSPITALS ER'S INCLUDED * MINUMIN CHARGE TO GET CHECKED OUT $1,200.00 * BUT IF YOU ARE INDIGENT OR AN ILLEGAL IT'S FREE * I DO MY BEST TO AVOID DOCTORS & I TRY TO GET ALL MEDS FROM CANADA **************************
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OH YEAH I ALMOST FORGOT * IMPEACH OBAMMA *************
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