WASHINGTON, Dec. 14 The National Organization for Rare Disorders (NORD) today called upon Congress to put an immediate end to lifetime and annual health insurance caps. In a full-page ad in The Politico, a newspaper distributed widely on Capitol Hill, NORD said the current Senate health reform bill includes loopholes that would allow caps to continue for most Americans, contrary to what many people believe.
"NORD supports health care reform and welcomes the promises made by President Obama and Congress to eliminate lifetime and annual caps," said NORD President Peter L. Saltonstall. "However, under the current version of the Senate bill, caps would continue for several years for many people and would never be eliminated for others."
Private insurers often set lifetime or annual caps on the amount of health care coverage an individual may have. For Americans with chronic diseases, rare disorders, or major medical crises, this can lead to financial crisis or bankruptcy when insurance benefits are exhausted.
The health care reform debate has focused a spotlight on this problem. President Obama promised this fall that the caps would be eliminated under health reform, noting that insurance companies would "no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime." Originally, the Senate health reform debate also advocated eliminating the caps.
However, the current version of the Senate bill provides for "grandfathering" existing insurance plans so that existing plans would be subject to annual lifetime caps indefinitely. The bill also allows self-insured plans to impose annual or lifetime caps indefinitely, which means that many people with employer-provided insurance would still be subject to caps. Even when the bill would require eliminating caps, it would not require doing so for several years.
Earlier this fall, NORD sent a letter to all members of Congress and President Obama outlining four measures that it considers essential to any health reform plan: prohibiting discrimination based on pre-existing conditions; protecting patients against catastrophic out-of-pocket costs and lifetime or annual caps; prohibiting insurers from canceling policies as a result of medical diagnoses; and including tax credits and other direct financing support to assure that all Americans can afford coverage.
SOURCE National Organization for Rare Disorders (NORD)