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The War on Children's Health Coverage, After The Veto

by PRWEB.com - Oct 10,2007

Washington, D.C. (PRWEB) -- Children's advocacy groups, including the Children's Defense Fund (http://www.childrensdefense.org/site/PageServer?pagename=newsroom_20071003_SCHIP), are lobbying more than thirty Republican Congressmen, in a crusade designed to get enough votes to successfully override President Bush's veto of the Children's Health Insurance Program. However, children's groups claim that even if the override campaign proves victorious, that still may not be enough.

If Congress overrides the President's veto and 10 million more children are made eligible for insurance coverage, obstacles still remain for insured children to actually obtain medical treatment. Children's advocacy groups point out that health insurance companies have resorted to "increased denials of medical treatment." "Not medically necessary" is a common reason given by health insurance companies to deny approval of treatments, especially expensive treatments related to cancer.

Health insurance companies have successfully lobbied for protection from State legislatures. The State of Texas recently revised health insurance laws creating additional administrative hurdles that must be cleared by consumers to dispute a denial of medical treatment. Consumers are required to exhaust insurance company appeals before seeking government and legal assistance. The rub is that insurance companies do not provide information to new policy holders as to rights of appeal or the company's appeal guidelines. Guidelines are not given to policy holders with their policies and are not generally made available on the Internet.

Consumers must possess a certain degree of sophistication to realize the need for appeal guidelines and how to timely request them or lose their right to appeal. Most consumers are not able to decipher insurance policies, request additional information, file appeals and request reconsiderations with the insurance company. After insurance company appeals are successfully completed the consumer must start over with obtaining government rules, laws and forms to continue the appeals process. Most consumers cannot afford a lawyer to appeal an insurance company denial and end up without needed medical treatment for themselves and their children.

Michael Moore's movie "Sicko" exposes how far an insurance company will go to deny medical treatment and services. Denials of medical treatment range from rejection of cancer treatments to denials of plastic inhalation tubes for children with serious asthma, and even refusal to pay for emergency ambulance services because the consumer failed to obtain prior approval.

In addition to denials of claims, insurance companies continue to increase premiums, co-pays, deductibles and keep adding more bureaucratic roadblocks for children who need medical care. Children's advocacy groups say that the President's veto is just the latest in series of setbacks for children's healthcare.

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Related news
House fails to override children's insurance veto by MarketWatch.com posted on Oct 18,2007
Bush to veto health insurance bill by AP-News posted on Dec 12,2007
Health groups work for kid's insurance by AP-News posted on Sep 25,2007
House to Test New Kids' Health Bill by Time.com posted on Oct 25,2007
Congress OKs Expanded Kids' Health Care by AP-News posted on Sep 28,2007
Senate nears vote on children's health bill under veto threat by President Bush by The-Daily-Dispatch posted on Aug 07,2007
Child Health Insurance Bill Faces Veto by AP-News posted on Jul 16,2007
House fails to override kids' health insurance veto by USATODAY.com posted on Jan 23,2008
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Comments (2 posted) 
  • I agree with Keith. The problem is this bill is another baby-step toward government-provided healthcare for everyone, which would be a disaster. Just consider how bloated and unsustainable Medicare and Medicaid have become. I am also a bit disturbed that Michael Moore's "Sicko" is cited as an authoritative source for information on the health care system in the U.S. Shame on you, InsuranceHeadlines.com. Let's get serious.
  • (Posted on October 31, 2006, 10:01 am David Essic)

  • I don't consider a 25 year old with income of $80,000 to be a child in need of government funded health insurance.
  • (Posted on October 31, 2006, 10:01 am Keith)



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