Washington Insurance Commissioner Mike Kreidler and the state's largest individual health insurance provider exchanged barbs Friday over individual children's health coverage.
Kreidler, reacting to Regence BlueShield’s announcement that it will no longer offer individual health insurance policies for children, ordered the insurance company to halt what he said was the company’s illegal age discrimination.
In reply, Regence accused Kreidler, who is running for re-election, of “gross politicization of such a complex regulatory problem.”
The exchange is a result of newfederal rules created under the federal health care law that prohibit insurance companies from denying health care coverage to children with pre-existing medical conditions.
Kreidler accused Regence, which writes 48.5 percent of the individual health care policies in Washington, of “pulling stunts and misleading the public about health reform.”
While the insurance commissioner can’t order companies to offer insurance, he can, under a 2000 state law, prohibit them from offering health insurance only to specific age groups. If Regence wants to offer individual policies, it must offer them equally to people of all ages, Kreidler spokeswoman Stephanie Marquis said.
Regence said it is studying how the commissioner’s order will affect its ability to offer individual policies in Washington.
“While more than 10 carriers have deserted Washington’s individual market – leaving three today – Regence has continued to insure these members despite losses of more than $33 million in the last three years,” the insurance company said.
The insurance commissioner countered that the other two major insurance providers in the individual market, Group Health and Premera, continue to offer individual policies for children.
“We worked hard with the large health insurers to accommodate their concerns and most, including Premera and Group Health, did the right thing,” Kreidler said. “Frankly, Regence deserves the backlash from its decision. It overreacted and now finds itself in violation of the law.”
Regence said its was “shocked” at Kreidler’s order. The company’s statement said that during several conversations with the commissioner and his staff, no one mentioned that Regence’s plan would violate the law.
Washington is not alone in dealing with insurance companies reluctant to accept the new rules. Companies nationwide have complained to the Obama administration that the new law as interpreted earlier this year would allow parents to sign up for coverage whenever they learn their child has an expensive illness.
To address that concern, the administration urged individual states to set up yearly enrollment periods for an individual policy. Kreidler set up a Nov. 1 through Dec. 15 enrollment period.
Insurance companies in other states have told insurance officials they may drop out of the individual children insurance business, but negotiations continue.
While several states have laws like Washington’s that prohibit age discrimination in insurance policies, Washington might be the only state thus far to invoke that law, according to Kreidler’s office and federal officials.
The dispute doesn’t affect children covered under group policies. Regence said it won’t deny coverage to children when the child is not the sole subscriber.
Individual child policies are needed when parents’ employers don’t offer family coverage, or if parents can’t afford care for the entire family. Child policies cover persons under age 19.