Mark Webb ran into insurance roadblocks in two different directions. It started with trying to help his daughter Meagan find a health insurance policy...

Mark Webb ran into insurance roadblocks in two different directions.

It started with trying to help his daughter Meagan find a health insurance policy when she recently moved from Florida to Canton, where he lives. Meagan found local employment, but the new job offered no health benefits.

When she applied for a health insurance policy, she was turned down by insurers because of a pre-existing condition linked to a recent surgery, he says.

Next, Mark Webb tried to find a policy that covered just Meagan’s son, Davin. Again, he got nowhere.

“We have found in Georgia that there are no child-only policies [sold],’’ Webb says.

The absence of new children-only policies began with the enactment of the health care reform law. The Affordable Care Act required child-only insurance policies to accept kids with pre-existing medical conditions, starting Sept. 24, 2010.

But in many states, including Georgia, several major insurance companies, including WellPoint, UnitedHealthcare and Aetna, decided to stop offering new individual policies that cover children only. The insurance industry explained that under the new federal requirement, a parent could wait till a child gets sick before purchasing coverage. That would cause soaring costs for insurers, the industry said.

Parents purchase child-only policies when an employer doesn’t offer dependent coverage, or when they can’t buy coverage for themselves due to cost or a medical condition. Estimates on how many children currently are covered under these policies range widely, from 140,000 to 700,000.

Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, an industry trade group, says the reform rule banning pre-existing conditions for children led to ‘’unintended consequences.’’

“Health plans are having to make some very difficult decisions,’’ he said.

The state Insurance Commissioner’s Office said Thursday that the reform law has shut down Georgia’s market for child-only coverage, except for policies that existed before Sept. 24. Nothing in state law requires insurers to offer these policies, said Steve Manders, director of insurance product review for the insurance office.

Holly Lang of Georgia Watch, a consumer advocacy organization, says the group has fielded queries from several families looking for a policy to cover a child.  ”It is disappointing that our state’s insurers have decided to abandon Georgia’s children,” Lang says.

Webb’s daughter will have to be uninsured a total of six months until she becomes eligible for the state pre-existing condition pool, set up as part of health reform. Davin will have to wait the same amount of time before he qualifies for PeachCare, the government program for uninsured children.

In the meantime, Webb still hopes they can find a private insurance policy for Meagan and Davin. “This highlights that there is a big hole for children,’’ he says.

Some states, though, have stepped in to fix the child-only policy problem. Jocelyn Guyer, co-director of the Georgetown University Center for Children and Families, said Thursday that California and some other states have passed or are contemplating laws to keep this coverage available for children.

A California law, in fact, barred insurers from the adult individual insurance market for five years if they didn’t offer child-only policies. “States where political leaders are taking some action are able to keep their child-only coverage,’’ Guyer said.

 

 


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Andy Miller

Andy Miller is editor and CEO of Georgia Health News

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