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Jan 08, 2007 - 10:30 AM
CONTACT: Jerry Flanagan, 310-889-4912; Jamie Court, 310-392-0522 ext. 327; or Judy Dugan,
Internal Documents Show Insurers Won't Sell Health Policies to Cops, Firefighters, Expectant Dads, Allergy & Acne Sufferers, etc.;
Schwarzenegger, Himself Uninsurable, Should Force CA Insurers To Sell To All PatientsSanta Monica, CA -- Firefighters, police officers, steel workers, expectant fathers, pregnant women and patients with asthma, acne, allergies, and toe nail fungus will not be sold health insurance policies in California, according to internal insurer underwriting guidelines made public today by the Foundation for Taxpayer and Consumer Rights (FTCR).
Under the insurer guidelines, Governor Schwarzenegger, who will announce his health insurance reform plan today in Sacramento, would be uninsurable because of his past heart valve replacement, recent leg surgery and past occupation as an athlete. FTCR said the documents show why Schwarzenegger's plan needs to force insurance companies to take all patients and must regulate the premiums charged.
"These documents show why Governor Schwarzenegger must demand that insurance companies sell policies to the uninsured if he wants to insure more Californians," said Jerry Flanagan, FTCR's Health Policy Director. "We now know why 1 in 5 Californians are uninsured, because insurers refuse to sell policies to people with pimples, allergies or a blacklisted occupation. Even the Governor himself would be uninsurable under the guidelines."
The guidelines also prevent Californians from going into business for themselves, because they cannot get insurance, said FTCR. Download underwriting documents for each company here:
* Blue Cross
* Blue Shield
* Health Net
The underwriting guidelines -- industry rules determining who will be allowed to buy coverage -- reveal that insurers deny applicants based on occupation, use of a wide range of common prescription drugs, minor health conditions or mere "symptoms" that have not been reported to a physician.
Some Uninsurable Occupations*:
Air Traffic Controllers
Public Utility Worker
* Blue Shield, PacifiCare
Some Uninsurable Rx:
Lamisil (toe nail fungus)
Some Uninsurable "Conditions":
Sickle Cell Anemia
Or, any "symptoms" for which physician was not consulted
FTCR called on Schwarzenegger to:
* Require insurers to take all buyers, regardless of preexisting conditions.
* Require insurers to base premiums on broad characteristics such as age categories and regional healthcare costs -- not on a buyer's specific medical condition.
* Regulate excessive health insurer profits and bloated overhead, just as auto premiums are regulated under Prop 103.
* Ban health insurance policies that fail to set limits on what patients can pay.
For more information on FTCR's recommendations, see:
* FTCR's letter to Gov. Schwarzenegger
* Jamie Court & Judy Dugan's Op-Ed
Schwarzenegger, who has received nearly $1 million in campaign contributions from insurers, has indicated he favors a plan that would require everyone to buy health insurance but has not mentioned long-overdue reforms of the insurance industry.
"How can Schwarzenegger require Californians to buy health coverage from insurers who have ultimate power to decide who to insure and can charge whatever they please?," said Judy Dugan, Research Director for FTCR.
Health insurers argue that the free market and minimal regulatory oversight gives them the ability to expand coverage. FTCR said the underwriting guidelines are undeniable proof of the hypocrisy of the health insurer's claim.
"Maximum flexibility means insurers can deny health insurance for any reason they choose," said Dugan.
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The Foundation for Taxpayer and Consumer Rights (FTCR) is the state's leading public interest advocacy organization. For more information visit us online at http://www.ConsumerWatchdog.org.
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