On Thursday, April 22, 2010, Reuters reported that “WellPoint … has specifically targeted women with breast cancer for aggressive investigation with the intent to cancel their policies…” Wellpoint responded today by saying that “this is simply wrong.” Interestingly, as I write this, the Reuters article with the allegations has been removed.
Wellpoint has categorically denied the allegations and strongly defends its practices. Also, Angela Brayly, CEO of Wellpoint, wrote a powerful letter to Secretary of HHS, Kathleen Sebelius, clarifying the inaccurate accusations. Ms. Braly told Secretary Sebelius, “both your statement and (Reuters reporter)Mr. Waas’ piece are inaccurate and grossly misrepresent WellPoint’s efforts to help prevent, detect, and treat the 1 in 8 of our 34 million members nationwide affected by breast cancer.”
The issue of rescission gets lots of media attention. The accusations make front page news. Yet, the truth/reality is much different. Personally, I have only seen one case rescinded in my 17 year career as a health insurance agent. In that case a woman applied for coverage through our agency online. She gave birth to a full term, healthy baby 6 months after applying for coverage. The application for coverage asked specifically if a woman is pregnant and asked the woman to put the date of her last menstrual period. (The current application asks if it has been more than 40 days since the last menstrual period.) So, in this case, the woman could not have given birth to a full term baby 6 months after applying for coverage because the human gestation period is 40 weeks or 9 months.
Insurance companies ask medical questions (medical underwriting) to prevent people from waiting until they are sick, or pregnant, to apply for coverage. If they did not do this; people would sign up for health insurance at the doctors’ office or in the hospital. Get treatment paid for by others. Then, cancel the coverage and reapply when they get sick, injured or pregnant again. This process is called “adverse selection” and it effectively ends the ability of people to pool resources to pay for high cost medical care, as health insurance does.
Rescissions happen rarely. When they do, it is likely that the facts in the case are not as reported in the press and parroted by politicians.
In my opinion, the Reuters article and Secretary Sebelius’s letter to Wellpoint is an example of the fear mongering that enabled the Patient Protection and Affordable Care Act legislation to be signed into law.