The Department of Managed Health Care fined Blue Cross of California $1 million for rescinding policies of almost 100 patients without rationale or due process.
It’s outrageous that Blue Cross has been dropping coverage for patients who actually seek care. California needs strong rules to stop this ‘use it and lose it’ practice.
More than that, the Department of Managed Health Care findings provide perspective in the health reform debate in Sacramento: While Blue Cross’ practices have been found illegal, this finding brings into question why we allow insurers to deny Californians coverage because of their health status at all.
We support the portions of the health reform proposals by the Governor and legislative leaders seek to prevent insurers from discriminating against those Californians with “pre-existing conditions.”
But these practices are also a case study about why any reform should not leave individuals alone and powerless at the mercy of big insurers–to pick and choose among us, to deny us coverage at their whim. In contrast, any reforms should focus on expanding group coverage instead, where we have the power of group purchasing.
This case study amplifies a report Health Access California co-released yesterday with The Access Project, The Illusion of Coverage: How Health Insurance Fails to Protect People When They Get Sick, available at www.accessproject.org. The report indicated the need for strong standards for insurers and employers about what “coverage” is.
We’ve complained about high-deductible, bare-bones products like Tonik in the market offered only to healthy people, all to avoid actually paying claims for care. This finding about Blue Cross simply takes this logic to the extreme: to rescind the policy if they actually need care. Remarkable.