Federal investigators have revealed that the largest health insurance company in the country, WellPoint, is using a computer program to identify women with breast cancer. Why? To drop their coverage. Murray Waas, a well-respected investigational journalist, states WellPoint “specifically targeted women with breast cancer for aggressive investigation with the intent to cancel their policies.” Last month, Waas reported that AIDS patients were being similarly targeted for rescission. That practice has been going on since at least 2002, as is well-evidenced by the unlawful cancellation and subsequent cover-up in the Jerome Mitchell case.
So far, its unpleasant, perhaps shocking, but no new conspiracy. Enter the Liz Fowler factor. The Wellpoint lobbyists reportedly “helped squash proposed provisions that would have required a third party review of its or any other insurance company’s decision to cancel a customer’s policy.” The Senate Finance Committee bill was written, in significant part, by former WellPoint VP Liz Fowler. Ms. Fowler left WellPoint in February 2009, to help the committee draft the Senate’s health care bill. Max Baucus thanked Fowler for doing so, saying that she was always helpful, always smiling… and perhaps sabotaging the bill the entire time. Baucus credits her for penning the foundation/blueprint from which nearly all of the proposed bills sprang from.
The House’s bill would have required that people who got cancellation notices be allowed to appeal to an “independent external third party” for review before being dropped or impacted. Under that rule, an insurance company could only cancel someone’s policy if there was “clear and convincing evidence of fraud.” But those provisions never made it to the final bill that was signed. Reuters claims that Wellpoint lobbyists “helped quash proposed provisions that would have required a third party review of its or any other insurance company’s decision to cancel a customer’s policy.”
Is this some prediction of future doom and gloom? No, it’s going on right now. People’s policies have already been canceled. WellPoint is claiming that the applications were fraudulent, but that’s both unlikely and unsupported. Waas says they were dropped “based on either erroneous or flimsy information.”
Though Harry Reid had promised to revisit the health care bill in the coming year, it doesn’t seem to be on the schedule. So WellPoint got protected, and patients with a serious illness have no recourse when an insurance company decides they cost too much and cancels them. The only coverage left to these patients, who may have paid in for many years without illness to date, would be the high-risk pools.
It would be nice if this were all some silly conspiracy theory. Unfortunately, the facts are pretty glaring. What else will surface? Perhaps we’ll find out about more of them as other behind the scenes details are unearthed.