Ian's Law: Protecting Patients From Insurance Industry Abuses

05/25/2011 02:35 pm ET

This week, I proudly introduced Ian's Law in the New York State Senate to protect patients from egregious insurance industry practices. Among other things, it makes it illegal for insurers to drop entire classes of insurance as a pretext to deny coverage to individual policyholders.

Here is a clip of the story from CNN:

The bill is named for Ian Pearl, a 37-year-old man with muscular dystrophy who lost his insurance when Guardian terminated the entire class of policies in the State that covered Ian and others. Mr. Pearl became ventilator-dependent in 1991 and relies on a skilled nursing benefit under his insurance policy to receive care that has kept him alive since he suffered respiratory arrest.

An internal document from the insurer, released as a result of a legal challenge, showed that company officials justified dropping the entire line of policies statewide in order to get rid of "the few dogs", like Ian Pearl.

The practice of terminating an insurance policy line as a pretext to dropping coverage for individuals who need it most is not only absolutely disgraceful - it's a matter of life and death. This bill holds the insurance industry accountable and protects patients like Ian - and other individuals who have paid for insurance coverage - from being thrown off when they get sick.

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.)

These people are not dogs, they are the struggling families behind the paperwork, and we have a moral obligation to protect them from abusive insurance industry practices.

While I strongly support the federal health care reforms that include a robust public option, the states much do much more to protect people like Ian from these abhorrent practices. With New York leading the way, I am confident that we will pass these laws across the country.