HCAN on WellPoint: 'Murder By Spreadsheet'

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FireDogLake.com

HCAN on WellPoint: 'Murder By Spreadsheet'

by
David Dayen

Even as WellPoint targeted women with breast cancer and who were pregnant for investigation, it prided itself for having women at the helm such as Angela Braly, president and chief executive officer. (Reuters: Brendan Mcdermid)

Using some of the strongest language I've ever seen from this group,
Health Care for America Now basically charged WellPoint with murder
today, responding to the Murray Waas article
showing that the insurance giant systematically dropped breast cancer
patients from the rolls. HCAN spokesman Avram Goldstein released this
statement, intimating that criminal prosecutions should be pursued in
this case:

"WellPoint is committing murder by
spreadsheet, and it has to stop now. This is a matter of life and
death, and the executives and board members of WellPoint need to be
held to account to the fullest extent of the law.

"WellPoint's Blue Cross-Blue Shield companies' disregard for human
life to maximize profits is immoral and outrageous. The Reuters report
shows an unconscionable pattern of denying needed health care to line
the pockets of wealthy executives and shareholders.

"Today's disclosure provides more evidence of why Congress needed to
pass national health reform in the first place, and it also shows why
we need to curb the extraordinary influence of insurance companies so
they don't interfere with enforcement of the new law. We need the
forthcoming federal regulations to shine a light on the insurance
companies and hold them accountable for their bad practices."

Actually, what we needed is for groups like HCAN to ensure during
the debate that practices like this would truly get outlawed by the
Affordable Care Act. In actuality, insurance companies, led by
WellPoint, lobbied for changes to the restrictions on their business
and a de-fanging of the law. Much like in the current financial reform
debate, they ended up leaving a lot of the regulatory authority
open-ended and at the discretion of regulators, in this case the Health
and Human Services Secretary and the National Association of Insurance
Commissioners. Jon Walker laid out how WellPoint successfully removed independent third-party review of all rescission cases.

Reuters reports that WellPoint is under
federal investigation for singling out breast cancer patients and
dropping their coverage "based on either erroneous or flimsy
information." They also report that language in the House bill would
have protected these women, but it was removed in the Senate version of
the bill because "lobbyists for WellPoint and other top insurance
companies successfully fought proposed provisions of the legislation."

Max Baucus, head of the Senate Finance Committee, credits former
WellPoint VP Liz Fowler with writing the "blueuprint" of the bill, and
her name appears as "author" on the bill PDF released by the committee
[...]

As you can see, the Senate bill does not mandate either independent
third party review or the continuation of coverage while the review is
taking place. Theoretically it's possible for the Secretary of HHS to
require a similar independent third party review framework for
rescission, but unlike the House bill, the Senate bill which ultimately
passed does not require her to do so - something WellPoint actively
lobbied for.

The White House might argue that rescission is a thing of the past
because the law guarantees issue of health insurance, and with risk
adjustment insurers will have an incentive to even pick up sick
patients. However, in reality the risk adjustment mechanism is far
smaller than the liability of sick patients, and insurers will
undoubtedly work hard to avoid as many patients with pre-existing
conditions as possible.

We now have a whodunit, where we have to ask who in the Senate
pushed to eliminate the toughest regulatory restrictions from insurance
companies who obviously have no compunction against systematically
denying coverage to breast cancer patients. Obviously Liz Fowler, the
former WellPoint VP, is a good place to start. So far, nobody privy to
those discussions has been willing to say on the record that Fowler is
culpable. But the insurance industry, already hated in the country, has
now committed what even cautious groups like HCAN call murder. Covering
for the culprit here is tantamount to being an accessory to the crime.

 

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