More than 300 patient advocacy groups took to pen and paper this week to tell Health and Human Services Secretary Sylvia Mathews Burwell health insurers are discriminating against the sick, despite the goals of the Affordable Care Act.
Insurer tactics, which the industry defends as legitimate cost control measures, are “highly discriminatory against patients with chronic health conditions and may…violate the [law’s] nondiscrimination provisions,” the letters stress.
Concerned groups include the AIDS Institute, the Epilepsy Foundation, the National Alliance on Mental Illness, the American Lung Association and the National Kidney Foundation. They claim insurers are charging exorbitant rates for prescription drugs, saddling costs with policyholders and severely narrowing the choice of doctors and hospitals for those with chronic conditions.
Indeed, some plans are requiring patients to pay 30% or more for drugs that cost several thousand dollars a month, such as HIV drugs, cancer medications and multiple sclerosis treatments. The concern, however, is that insurers behind the plans are “singling out certain conditions” by putting some medications on higher-cost tiers, the Washington Post reports.
Insurance industry trade group America’s Health Insurance Plans (AHIP) maintains carriers are not discriminating against those with chronic conditions, as consumers have multiple plans through state and federal health exchanges.
“There are plans on the exchanges that are right for people who have these health conditions,” AHIP spokesman Brendan Buck told the Washington Post.
State insurance commissioners—who are in charge of consumer protection—appear to be divided on the issue of whether discrimination is “creeping back” into health insurance. Washington state commissioners Mike Kreidler believes “there is no question,” while Kansas’ Sandy Praeger is undecided.
Praeger did urge the Obama administration to take a formal stand on the issue, however.
“They ought to make it very clear that if there is any kind of discrimination against people with chronic conditions, there will be enforcement action,” Praeger told the Washington Post. “The whole goal here was to use the private insurance market to create a system that provides health insurance for all Americans.”
The HHS is said to be preparing a formal response to the concerns.
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