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Ian's Law: A Look At A Key Piece Of Health Care Reform Legislation

by: robert.harding

Fri Nov 06, 2009 at 20:38:03 PM EST

Put yourself in Ian Pearl's position. You were diagnosed with muscular dystrophy shortly after your birth and have been confined to a wheelchair since you were six years old. Even though you were physically disabled, your brain is fully functional and you are striving to be the best you can be.

But then it happens. At 19 years old, you have a life-threatening complication that leaves you with one option: If you are to live, you must breathe with the help of a ventilator.

And through it all, through the life-threatening complications you had to endure along the way and through everything you have been through since you were born, who would have thought that it was a health insurance company that could be the thing that kills you.

That is the life story of Ian Pearl, a courageous man who shouldn't have to deal with the greed of Guardian Life Insurance Company.

Ian's story is better told by him, but here's the summary: Guardian decided that they were sick of covering Ian. At first, they pulled the health care plan that covered everyone in his dad's company in New York. That could be seen as a general move not targeted at Ian, but with some digging, Ian found that it was because of him and others with serious medical issues that Guardian made this decision. According to Ian's account on Huffington Post, Guardian created a "hit list" of their insured customers who were costing them the most to cover. These members were referred to by Guardian's top officials as "dogs" and "trainwrecks" because of their health conditions and their cost to insure. Ian was one of many targeted by Guardian, a process that included certain members like Ian having private investigators look for anything to cancel the plan so Guardian could save money.

It's not like Guardian couldn't afford to cover Ian and others in similar situations (from Ian's post):

While all this was going on, Guardian reported $7.5 billion revenue, net income of $437 million, and available capital of $4.3 billion in 2008. Unlike small businesses, Guardian's financial strength remained unscathed by the economic downturn.

What Guardian did was remove a plan they offered from an entire state all because of a select few of their insured who were seen as too costly.

Enter Senator Eric Schneiderman, who introduced S6263 or "Ian's Law" in the New York State Senate. The bill "provides enhanced consumer protections in the event of an insurer's discontinuance of coverage, including requiring approval of the superintendent and notice to policyholders." Specifically, it would prohibit insurance companies from doing what Guardian did: Canceling a whole class of a policy they were offering. With Ian's Law, the insurance company could not cancel this plan unless they received approval from the state Insurance Department.

How is this law different from current law? Currently, it is illegal to cancel someone's insurance because they have chronic health problems like muscular dystrophy. Thus, it would have been (or perhaps IS) illegal for Guardian to cancel Ian's policy. But nothing prevents them from pulling a whole class of insurance. Of course, if they did so because of those who they insure that have chronic health conditions, that IS illegal and should be dealt with and the individuals responsible should not just be held liable via civil action, they should also face criminal charges. Because in the case of Ian Pearl, this is life and death. And when insurance companies are playing games with people's lives, they should face serious punishment.

For more on this story, watch the video below from yesterday's press conference introducing Ian's Law. The full text of the bill is below the fold.

This bill would prevent health insurance companies from doing what Guardian did: Pulling coverage in the name of profit. That was the motive in the case of Ian and others. They were seen as "dogs" and "trainwrecks" because they were actually in need of their insurance and thus costing Guardian. Not that Guardian was hurting for the money. They still have their billions. But they wanted more. So they put Ian in a situation where he is now fighting for his life.

Ian's Law is important and while it would only apply to New York, it should be a law that every state introduces and passes and should become a federal law so that we can prevent insurance companies from deciding who they want to cover and who will be the cheapest to cover.  

There's More... :: (0 Comments, 3245 words in story)
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