iPhone app iPad app Android phone app Android tablet app More

Featuring fresh takes and real-time analysis from HuffPost's signature lineup of contributors
Jane Hamsher

Jane Hamsher

Posted: April 22, 2010 02:18 PM

Wellpoint Lobbyists Axed Key Protections for Breast Cancer Patients From Health Care Bill

What's Your Reaction:

Federal investigators have told Reuters that WellPoint, the country's largest insurance company, is using an algorithm to identify women with breast cancer for the express purpose of dropping their coverage.

Murray Waas writes that WellPoint "specifically targeted women with breast cancer for aggressive investigation with the intent to cancel their policies":


The women all paid their premiums on time. Before they fell ill, none had any problems with their insurance. Initially, they believed their policies had been canceled by mistake.

They had no idea that WellPoint was using a computer algorithm that automatically targeted them and every other policyholder recently diagnosed with breast cancer. The software triggered an immediate fraud investigation, as the company searched for some pretext to drop their policies, according to government regulators and investigators.

Wellpoint claimed that these women had made material misrepresentations in order to justify dropping their coverage, but Waas says they were dropped "based on either erroneous or flimsy information." Last week, Waas reported that AIDS patients were being similarly targeted for recision.

The version of health care bill passed by the House of Representatives would've allowed these women to apply to an "independent external third party" for review before being dropped. It also would have required Wellpoint to keep their coverage in place until the board made its determination, and policies could only be canceled in cases with "clear and convincing evidence of fraud."

Those provisions were not included in the Senate Finance Committee bill, however, which became the basis for the final health care bill signed by the President. Reuters says that Wellpoint lobbyists "helped quash proposed provisions that would have required a third party review of its or any other insurance company's decision to cancel a customer's policy."

As Marcy Wheeler reported last year, the Senate Finance Committee bill was written by former WellPoint VP Liz Fowler, who left her position at the insurance company in February 2009 expressly for the purpose of helping the committee to draft the health care bill:

picture-132.png

And when Max Baucus did a "victory lap" after the health care bil passed, he expressly thanked Fowler for her work:

I wish to single out one person, and that one person is sitting next to me. Her name is Liz Fowler. Liz Fowler is my chief health counsel. Liz Fowler has put my health care team together. Liz Fowler worked for me many years ago, left for the private sector, and then came back when she realized she could be there at the creation of health care reform because she wanted that to be, in a certain sense, her profession lifetime goal. She put together the White Paper last November-2008-the 87-page document which became the basis, the foundation, the blueprint from which almost all health care measures in all bills on both sides of the aisle came. She is an amazing person. She is a lawyer; she is a Ph.D. She is just so decent. She is always smiling, she is always working, always available to help any Senator, any staff. I thank Liz from the bottom of my heart. In many ways, she typifies, she represents all of the people who have worked so hard to make this bill such a great accomplishment.

Susan Bayh, wife of Indiana Senator Evan Bayh, is on the WellPoint board. Bayh threatened to join Joe Lieberman in a filibuster of the health care bill if a public option was included, something that would very much threaten WellPoint profits -- which have soared in the past year. Susan Bayh's compensation for her role on the WellPoint board includes valuable stock options.

Before the health care bill passed, Harry Reid promised Bernie Sanders that there would be a vote on the public option "in the coming months," and anonymous "hill aides" said that they were looking to use the reconciliation process, such that only 50 Senate votes were needed for passage. In exchange, Sanders offered to give up on his plans to offer a public option amendment. A public option would mean that at the very least, breast cancer and AIDS patients who were unfairly dropped from private insurance plans had some place to go for medical coverage.

But the Senate budget committee is marking up next year's budget right now, and according to the Hill, there are no plans to include reconciliation instructions for health care. Which means that for the next year, any plan to "fix it later" would require 60 votes in the Senate -- but the public option doesn't have 60 votes. Which means Reid punk'd Sanders, Jeff Merkley and other progressive Senators to secure their votes.

It's shameful that Wellpoint lobbyists were successful in keeping key protections for those with breast cancer, AIDS and other serious illnesses out of the Senate bill. But it's even more shameful that Harry Reid has no intention of keeping his promise to fix the health care bill any time soon -- and that members of the Senate with serious conflicts of interest will profit handsomely as a result.

 

Follow Jane Hamsher on Twitter: www.twitter.com/janehamsher

 
 
  • Comments
  • 343
  • Pending Comments
  • 0
  • View FAQ
Comments are closed for this entry
View All
Favorites
Recency  | 
Popularity
Page: 1 2 3 4 5  Next ›  Last »  (10 total)
03:24 PM on 06/12/2010
The only help for reform is if there is extensive regulatory reforms that are put in place to hold the companie's feet to the fire. Health reform was just the beginning. The legislation was watered down by industry lobbyists. But not entirely so so that the legislation can't stil have teeth in it through discretionary regulation and rulemaking.

http://www.commondreams.org/headline/2010/04/24-1

http://www.reuters.com/article/idUSTRE62G2DO20100317

http://www.cjr.org/the_audit/reuters_is_excellent_in_diggin.php
04:01 AM on 06/07/2010
WellPoint canceled all their breast cancer patients, but other companies did the same things.

Assurant canceled their HIV positive patients:

http://www.jsonline.com/business/88878472.html

http://www.reuters.com/article/idUSTRE62G2DO20100317

http://www.huffingtonpost.com/murray-waas/insurance-company-must-pa_b_289841.html

http://krugman.blogs.nytimes.com/2010/03/17/demons-and-demonization/
photo
JustBNice
make friends with everyone
09:18 PM on 04/27/2010
This should be headline news in every major newspaper.

The Dems are not much better than the Repubs.
photo
HUFFPOST SUPER USER
GatoPreto
09:45 PM on 04/25/2010
We can thank Jane Hamsher for being one of the only people on the left to call the Insurance Industry Bailout for what it is.
05:03 PM on 04/25/2010
I wish there were a place called Hell that these people would rot in.
11:34 AM on 04/25/2010
Is it really necessary to demonize Lis Fowler? She has spent her entire professional carrier in public service and academia, but for her 2 years with Wellpoint. Did Wellpoint implant a chip in her neck and turn her into an anti-consumer zombie just before she returned to public service? Some people apparently think so. While kicking people with serious illnesses off of insurance plans is worse than horrible, and insurance companies have clearly used "consumer fraud" as an excuse to rid their roles of people who need care, let's not make the mistake of suggesting, as the author clearly does, that Liz was a hidden industry lobbyist wearing sheep's clothing as she wolfed down consumer protection. I share everyone's frustration--including our President's--that health care reform is so far only a work in progress, but we do not need to scapegoat innocent people to make our point. What we need to do is achieve a progressive consensus during the six months that remain before the November elections.
HUFFPOST SUPER USER
vanmungo
02:20 PM on 04/25/2010
I'm glad Liz Fowler's mother has taken the time to weigh in on this article.

We judge people by their deeds. Liz Fowler authored a bill that expressly excluded third-party review of private insurers' dubious rescission dictates of legitimate, paying customers.

Liz Fowler thereby certified herself as a member in good standing of the private health insurers' Association of Vampires.

Thanks, Liz, and have a nice eternity dodging those pitchforks! (along with all the Democratic fakes and phonies who voted for this monstrous corporate bailout masquerading as reform)
04:33 PM on 04/25/2010
And what about the place in hell for people who prefer to demonize than find a constructive solution? I never met Ms Fowler, but I would trust my health policy decisions to her before I would trust the lynch mob hysterics on this web site.
HUFFPOST SUPER USER
vanmungo
03:55 PM on 04/25/2010
We judge people by their deeds. Liz Fowler authored a bill that expressly excluded third-party review of private insurers' dubious rescission dictates of legitimate, paying customers.

Thanks, Liz, and have a nice eternity dodging those pitchforks! (along with all the Democratic fakes and phonies who voted for this monstrous corporate bailout masquerading as reform)
photo
HUFFPOST SUPER USER
rougebaisers
06:29 AM on 04/25/2010
How could there have been a doubt in anyone's mind that this bill is a farce, a miserable zero, a gift to all the powers that ARE the problem with health care in America.
10:57 PM on 04/24/2010
The White House has now got into the act. From the White House communications director:
http://www.whitehouse.gov/blog/2010/04/23/a-practice-will-soon-be-illegal

And McJoan at Daily Kos: Feinstein taking aim too:

http://www.dailykos.com/storyonly/2010/4/24/860090/-Feinstein-Argues-to-Plug-HIR-Rate-Hike-Loophole

http://krugman.blogs.nytimes.com/2010/03/17/demons-and-demonization/
07:45 PM on 04/24/2010
Health care reform? What health care reform? Oohhh . . . you mean Health Insurance windfall!!
01:13 AM on 04/24/2010
Jane Hamsher's one of the most ardent supporters of what is right for the public through progressive reform, but I think/hope she's jumping the gun. The linked article doesn't specifically rule out a P.O. vote and one of the option's staunchest supporters says: “I would also hope we could have a public option as well,” Sen. Bernie Sanders added.

Another for the PO said:
"There's a bunch of things I'd like to see reconciliated and we're going to push on that front," said Sen. Jeff Merkley (D-Oregon), coining a new term. Harry Reid has promised Merkley and Sanders a vote on the public option. Doing it through reconciliation would give it a reasonable chance of passage."

GET ANGRY and GET MOVING!

Adopting and amending Rep.Grayson's 4page Medicare Buy-in bill to include drug price negotiation/re-importation would save hundreds of billions over 10 years, Pharma be damned, aside from being a fiscally sane no-brainer. http://www.huffingtonpost.com/2010/03/19/grayson-pushes-public-opt_n_506052.html

Who's your Rep/ How to contact them: http://www.congressmerge.com/onlinedb/index.htm
Your Rep's stand on this: http://whipcongress.com/
The Democratic leaders:
Speaker Pelosi http://www.speaker.gov/contact/
Majority Leader Reid http://reid.senate.gov/contact/index.cfm
Progressive advocacy groups:
Change Campaign Committee http://boldprogressives.org/home
Medicare for All http://www.medicareforall.org/pages/Home
Physicians for a National Health Program http://www.pnhp.org/
photo
Actraiser
Medicare for all!
10:45 AM on 04/24/2010
Ms. Hamsher is absolutely NOT jumping the gun. The time for all reform minded people to act was late last year when the Senator from Connecticut threatened to filibuster over the public option and medicare for all, and the President did not pursue him over it.

http://www.huffingtonpost.com/2009/12/21/lieberman-obama-never-pre_n_399355.html

Why didn't the President pursue him with the same gusto and persistence he used to convince Congressman Kucinich to vote yes on the bill?

Their excuse was that they needed 60 votes. And when Scott Brown was elected and that excuse was negated, even the most ardent supporters of the public option, including Senator Rockefeller were backing away.

http://www.politicsdaily.com/2009/10/04/jay-rockefeller-s-health-care-moment-45-years-in-the-making/

http://www.huffingtonpost.com/2010/02/22/rockefeller-not-inclined_n_472393.html

The only way a public option or medicare for all will ever be passed is if all democrats start and continue to demand it. Those links you provided are an excellent start. I write to my representatives regularly and I hope everyone else does the same.
03:07 PM on 04/24/2010
My point is that the linked article doesn't support her conclusion that " Reid punk'd Sanders, Jeff Merkley" for their vote last month and has no intention to allow a vote for a public option. She's reading more into this article than I could see: http://thehill.com/blogs/on-the-money/budget/93351-senate-democrats-budget-to-include-reconciliation-instructions wherein Senator Sanders is reported advocating for a P.O. vote! That's jumping the gun in this instance.

So what do we know:
1) Obama dealt away the P.O.to the HC industry early on and had no intention to fight for it. (Jane's FDLake chronicled it all last year.)

2) Senate gets late magical courage and 41 signatories (not 51) for an unspecified P.O. Reid's C.O.Staff has dinner with Rahm
http://www.huffingtonpost.com/2010/04/08/power-struggle-inside-the_n_529884.html
and Reid buys off petition movement with a promised P.O. vote: http://www.huffingtonpost.com/2010/03/19/reid-promises-separate-pu_n_506272.html
03:13 PM on 04/24/2010
3) Senator Merkley is involved in getting a PO reconciliation vote: "There's a bunch of things I'd like to see reconciliated and we're going to push on that front," said Sen. Jeff Merkley, coining a new term. Senate Majority Leader Harry Reid (D-Nev.) has promised Merkley and Sanders a vote on the public option. Doing it through reconciliation would give it a reasonable chance of passage." http://www.huffingtonpost.com/2010/04/20/hawk-squawks-conrad-budge_n_545296.html

4) Articles from this week show Merkley and Sanders are positioning for a vote and NOW is the time for us to help them by call and writing or reps.

"The only way a public option or medicare for all will ever be passed is if all democrats start and continue to demand it."
Absolutely, Actraiser, allow me to be your first fan. My whole point is that I'm following this promised PO vote any way I can and see signs it's not dead. There shouldn't need to be any specific rules written since a Medicare buy-in passed under budgetary reconciliation is the same nature of bill as the fix just passed by the senate and the Part D thing Bush pushed thru.
HUFFPOST SUPER USER
THISTLE
11:57 PM on 04/23/2010
How can the Democrats allow this to happen, to women?
Where's Pelosi, where are the Democratic women senators?
As a Progressive, I am outraged by the fact that Reid & Pelosi
are allowing Wellpoint Lobbyists to do this. Since it looks
almost impossible for Reid, to win re-election, why doesn't
he finally stand up and fight for something this important,
this vital. It might even make women and men take another
look at him, and see he finally found that missing spine.
If he loses, he would go out as fighting to make sure
Wellpoint doesn't win this one.
HUFFPOST PUNDIT
springsm
01:03 AM on 04/24/2010
and Pelosi is doing what? As a bilateral breast cancer survivor, I am so angry with this behavior that I want to hit somebody. Beyond that it greatly saddens me to know for sure that women and women's health mean so very little to the people who are our insurers and Congress as a whole. It isn't just H Reid, it is ALL of Congress. Bipartisanship could have taken care of this...but oh no...let the women lose, we have to stop Obama. I pity judgement day for some of these people. *Who undoubtedly beat their chests, wave their bibles and arms every Sunday.". Okay..next..no viagra, no psa tests and for gosh sakes, not health insurance for PED or Prostate CA. Fair is fair.
05:13 AM on 04/25/2010
The bipartisan approach was a bigger joke than the bill we got. All both parties are offering are jokes with the democrats being bad and the republicans offering more of the same except higher rates.
photo
HUFFPOST PUNDIT
wethepeople3884
in Order to form a more perfect union ...
11:36 PM on 04/23/2010
If harry reid loses, he deserves it. I MEAN what kind of senate majority leader tries to trick their progressive members into voting for legislation and not offering up amendments that are supported by more americans than the bill itself was at the time. In fact, over 60 percent of america in poll after poll supported a public option while far less ever supported the actual bill being written in congress, No doubt most people polled never read the bill but that does not excuse the fact that they understood that the option would be highly beneficial and increase competition to lower profits and prevent the exact things happening written above. Reid is a sorry sac, he is a spineless coward - the only thing he leads is a preformed majority vote ie he doesnt actually do anything to help more progressive legislation pass and progressives should not pretend he is on our side or support him. In fact, a primary challenger would likely have a better shot at winning in nevada than reid himself who has proven beyond a doubt than when push comes to shove, reid will fall to his knees in shame every single time. Reid cant put up a fight, he doesnt even know the definition of the word.
photo
JDM73
male, 38, writer/draughtsman/ex-musician
07:17 PM on 04/23/2010
Sadly, we all knew what "fix it later" really meant.
photo
HUFFPOST PUNDIT
wethepeople3884
in Order to form a more perfect union ...
11:42 PM on 04/23/2010
yea harry reid deserves to lose his senate seat - the guy is a joke. He is the polar opposite of a leader, a spineless coward. I hope reid enjoy early retirement - it isnt his fault entirely though. Just look at harry reid, what kind of cruel joke did the dems pull on us when they decided this man would be the senate leader?
05:09 AM on 04/25/2010
and don't forget the republicans . . . and Reid wasn't the only democrat either. There were a few democrats especially those in the house who wrote better bills but I don't think there is any republican who offered more than compassionate prayer and higher rates.
05:28 PM on 04/23/2010
Interesting, especially since their CEO received a 51% raise last year. I guess the lesson in all of this is that murder does pay.
HUFFPOST SUPER USER
bellestarrr#1
she done him wrong
05:24 PM on 04/23/2010
This stuff by the insurance companies is disgraceful and that bill needs to be FIXED RIGHT NOW asap...if the senate thinks they are pulling the wool over our eyes with this one..they can forget it..if this stuff keeps THEY are the ones that are gonna need healthcare....people are tired of this stuff...