| The story of Ian Pearl is one that should anger every citizen. Ian was born with muscular dystrophy. Since that diagnosis, which came shortly after his birth, he has lived through a number of setbacks and life-threatening complications.
But what happened to Ian should not happen to any American. I will let Ian's own words tell the story:
After decades of medical emergencies, we still weren't prepared for the latest crisis -- this one created by the same insurance company that once saved my life. Guardian abruptly withdrew our health plan from all policyholders in New York where my father's business is based. Guardian offered a 'replacement' plan with low benefits and no home nursing benefits. They knew that I would never survive with such a plan, but they didn't care.
Suspecting that this action was related to the high cost of my care, we filed a lawsuit and have asked the U.S. Department of Health and Human Services to enforce existing federal laws and require Guardian to continue my health plan. Without federal intervention, I will lose this insurance, and that would be a death sentence.
Our lawsuit uncovered insurance company documents that confirmed my suspicion that I'm a target of discrimination. The documents revealed Guardian had compiled a "hit list" of its costliest members, including patients with muscular dystrophy, multiple sclerosis, brain injury, and paralysis. Guardian executives referred to us all as "dogs" and "trainwrecks," and they debated how and when to dump us from the rolls. Laws prohibited the cancellation of the individual members with serious chronic health problems, so Guardian opted to cancel the plan for all members of this specific health plan in New York, an action that violates federal law.
Because of this, Senator Eric Schneiderman announced yesterday that he was introducing S.6263 in the New York State Senate. The bill will be called Ian's Law and would protect those like Ian who are denied coverage they need by companies who don't feel like covering them.
Joined by patients and insurance reform advocates, Senator Eric T. Schneiderman (D-Manhattan/Bronx) announced the introduction of major legislation today that protects patients from egregious insurance industry practices. "Ian's Law" (S.6263) makes it illegal for insurers to drop entire classes of insurance as a pretext to deny coverage to individual policyholders; requires insurance companies to get prior approval from the Insurance Department before discontinuing a class of insurance; and expands the minimum length of time - to 18 months - that an insurance company must ensure that policyholders with total disabilities receive continued coverage after losing their policy due to the statewide cancellation of an entire class of policies.
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Ian's Law requires insurers to prove they are not dropping a line of coverage as a pretext for dumping an individual policyholder. That means:
Insurers must get permission from the Insurance Department to drop a line of coverage - and notify impacted policyholders when they apply.
Insurers must show the following to the Insurance Department: the claims and premium rates for each policy issued in the class, the historical profits and losses for the line of policies, and any other information requested by the Department. The Department must look at this information to determine if the dropping of a class of policies statewide is merely a pretext for dropping coverage of a particular individual.
Policyholders are given an opportunity to comment on the impact of the dropped policies, and the Insurance Department must take these comments into account.
Ian's Law also empowers consumers to challenge insurance companies in court if they discontinue lines of coverage in violation of the new law. In addition, policyholders with severe disabilities will receive at least 18 months of coverage if they lose their policies due to the cancellation of a class of policies. (Current regulations require such care for only 12 months.)
Ian's Law is already getting nationwide attention. The Washington Times has a piece on the bill and CNN has the announcement of the bill. Politics On The Hudson also had a write-up on the bill.
What happened to Ian Pearl should not happen to anyone. This should not only be a New York State law, but it should also be a federal law. Hopefully, the state legislature acts quickly on Ian's Law and in turn, motivates other states and the federal government to take action. |
