Making Health Progress While Waiting for Health Reform

People are losing their jobs and losing their health insurance.  But as the economic crisis deepens, some legislators remain reluctant to move forward on comprehensive heath care reform.

As people wait while we work to bring agreement on big picture health reform, we must take the small and immediately achievable small steps to bring increased coverage, certainty and affordability to health insurance.

We can begin by allowing parents to keep their young adult children, up to age 27, on their health insurance policy.  Young adults are the most likely to be without insurance and yet they are the least expensive age group to cover.   As of August 2008, at least thirty other states have some form of coverage for adult children. Such a law would immediately bring insurance to many young adults – allowing them to focus on gaining job experience without worrying about health benefits.

Wisconsin should adopt insurance rules many other states have in place to add certainty to those buying insurance. Far too many of us have purchased a policy only to find out later what we thought was covered was not.

Our laws with regard to pre-existing conditions are some of the most lax in the country. Illinois and Wisconsin join 16 mostly southern states that do not set rules on either defining or limiting restrictions on pre-existing conditions. Even Louisiana and Mississippi have a limit on how long an insurance company can hold past health history against a person when denying insurance coverage.

Wisconsin should limit, to one year, insurance restrictions for pre-existing conditions and should define a pre-existing condition by medical standards. If and only if you have been diagnosed with a medical condition should it be pre-existing. Eighteen states have already adopted a clear medical standard for pre-existing conditions. We can too.

If you are denied coverage or your policy is cancelled what can you do? We need to add fairness to Wisconsin’s insurance regulations by requiring insurance companies to offer a free independent review for anyone who wants to appeal a denied claim or a dropped policy. More than twenty states offer this service to citizens.

Other measures can help. Forms are too complicated. Different companies use different forms and ask questions in different ways. The Commissioner of Insurance should be empowered by the legislature to set a standard insurance form – Oregon has done so and Wisconsin can do as much.

For those with serious medical conditions, the state high risk pool HIRSP is available. Recent changes in the program have made it more affordable. But we need to do more. We should make it easier to get into the plan. We should also remove the one million dollar lifetime limit as the plan becomes more financially solvent.

Last week I joined over two hundred health professionals from Maiden Rock to Milwaukee to discuss changing Wisconsin’s health habits and our health care system.

Listening to people representing business, labor, hospitals, insurers and health workers – confirmed my belief there is growing consensus about what must happen to bring affordable and high quality health care to all. The challenge we face is gaining consensus among legislators on major reform efforts.

But I believe we can get broad agreement on the steps I have outlined.  And the journey of a thousand miles begins with a few important steps.

State Senator Kathleen Vinehout serves the 31st Senate District. She can be contacted by mail at Senator Kathleen Vinehout, P.O. Box 7882 Madison, Wisconsin 53707-7882 by phone at 877-763-6636 (toll free) or email at Sen.Vinehout@legis.wisconsin.gov