Proof of citizenship requirements takes its toll on Oregon health care

The federal mania for ID requirements, manifest as a requirement that you prove US citizenship in order to get state health benefits to which the feds contribute, has apparently taken a bite out of the butt of the group most sane people predicted would be hurt by the new requirement: legal citizens fully eligible for the benefits.

From Oregon Live:

PORTLAND, Ore. (AP) — According to a state report, more than 1,000 Oregonians have been denied access to health services under a new federal law that requires them to prove they are citizens.

State officials say they think almost all of the people affected are citizens. But they, or their parents, were unable or unwilling to round up all the required documents, according to a the recent report from the Oregon Department of Human Services.

The report looked at the experience of nearly 200,000 people in 125,000 Oregon families who had to prove their citizenship to get or retain state health services during the first six months the law was in effect — September 2006 through February 2007.

It found that 99 percent of them eventually were able to qualify, but that 1,011 Oregonians were cut out of state programs. Many of the people cut were children.

The law was designed to save money by ensuring that illegal immigrants do not get free health care on the government's tab. But an earlier Oregon study found that few noncitizens were receiving government-paid health care, and officials say few of the people denied coverage in Oregon under the new law are noncitizens.

Of those turned down for lack of proof, 91 percent came from English-speaking households, the report says. Only three Spanish-speaking adults were unable to document their citizenship.

The state tried to help people by checking Oregon birth certificates via computer for free. It also devoted thousands of hours to retraining employees and spent $44,000 buying certified copies of birth certificates and other documents from other states for applicants who could not afford them.

Do you mean to tell me that the federal lawmakers were unaware that a big chunk of US citizens does not run around with their certified birth certificates, and pretty much lacks the money and the knowledge to go about acquiring those birth certificates?

Blue Cross of California finds a sly way to profit

What better way to make a profit than to not spend money while collecting money from your customers? Apparently that thought occurred to Blue Cross of California, according to an investigation by the California Department of Managed Health Care

DMHC officials on Thursday informed Blue Cross of their intent to file an accusation against the company and issue a $1 million fine in the case. Under California law, health insurers must prove that members intentionally misrepresented their medical histories on policy applications to cancel policies. State investigators reviewed 90 cases from 2004 to 2006 in which Blue Cross canceled individual health insurance policies and found the company had violated the law in each case. According to state investigators, Blue Cross used computer programs and maintained a department to review the policies of members with chronic illnesses and women who became pregnant to consider cancellation. Blue Cross cancels about 1,000 policies annually in California. WellPoint, the parent company of Blue Cross, cited "factual errors" in the investigation and said the "vast majority" of policies canceled by the company are proper.

Blue Shield of California's unique way of "managing" claims

What's a poor insurance company to do when one of it's policyholders has the audacity to file a claim? Well, they certainly don't want to encourage that kind of behavior, so....

A new lawsuit accuses Blue Shield of California of looking for reasons to cancel the policies of people who file claims:

...the lawsuit, filed on Thursday, is "unusual" because "it seeks to force Blue Shield to stop the practice, rather than demand compensation for a policyholder who lost coverage." The lawsuit might "have a wide effect if it succeeds because Blue Shield alone has acknowledged canceling about 300 policies in the last two years," and the "outcome also could influence other insurers that collectively have revoked thousands of policies in recent years," the [Los Angeles] Times reports.

How do the insurers do it? Simple....if they can find a misstatement, or an omission of fact, anywhere in your application for the policy, they claim the right to rescind the contract for fraud in the inception. Now most people applying for a policy, or anything else that has an application as long as the ones for insurance, involving questions about health and lifestyle going back to your damn birth, are likely to make some mistakes. So the insurers can, in effect, cancel your policy any time they want, at least if the law allows cancellation for all omissions and errors. They can just collect your premiums as long as they find that profitable, then spring the old fraud claim anytime you become unprofitable, undesirable, etc.

So the lawsuit is likely to center on whether the law allows these bastions of free marketeerism to cancel for any mistake or omission, even unintentional ones.

California's insurance Commissioner appears to have taken the side of policyholders on this one. According to one report, state Insurance Commissioner Steve Poizner said:

I am very concerned about the practice of post-claims underwriting...The law does not permit a health insurer to agree to provide coverage and then wait until a claim comes in to decide whether to pay for the medical care a policyholder needs. Specifically, I am concerned about insurers rescinding coverage for small, inadvertent and innocent omissions on applications for coverage.

You and all the rest of us "lucky" enough to be insured, Mr. Poizner.

And yes, I am involved in attempting to get coverage of a medical claim as I write. Or at least to get a comprehensible explanation of what the coverage is, or why there is none. The last time I went through this, I spent about 8 hours dealing with Blue Cross (God knows how long Blue Cross spent) getting a $28 reimbursement for two trusses while I waited for hernia surgery.

And just think, this is the kind of "free market solution" the Republicans keep pushing for the health care crisis in America.