That was easy! The WSJ reports that all the HHS had to do was ask nicely and the question of whether children with pre-existing conditions got relief under the new health reform bill was solved:
Insurers said they would comply with regulations the government issues requiring them to cover children with pre-existing conditions, after a dispute with lawmakers over interpretation of the new health-care legislation.
The Obama administration has made near-immediate coverage for sick children a priority in its health-care overhaul. But shortly after the bill's passage last week, insurers contended that the law didn't require them to accept sick children until 2014.
The insurance industry's lobby, America's Health Insurance Plans, initially said the law meant only that they needed to cover treatments for sick children who already were customers.
Kathleen Sebelius, secretary of Health and Human Services, sent AHIP president Karen Ignagni a letter Monday pledging to issue new regulations in coming weeks to clarify that insurers must take applications from sick children starting in September. "Now is not the time to search for non-existent loopholes that preserve a broken system," Ms. Sebelius said.
AHIP said de-linking the requirement to insure sick children from the law's mandate that everyone buy health-insurance coverage, which goes into effect in 2014, could drive up prices in the meantime. But the group said it would do whatever HHS tells it to do.
That was easy!
It's worth remembering that, within reason, the insurance companies can play by any set of rules as long as they all play by the same rules. If some companies continue to deny coverage to families of children with pre-existing conditions, the firms that take them on will need to restructure as philanthropic enterprises.
And do keep in mind - since the insurers will be able to raise rates, they won't be paying for these kids (lib fantasies notwithstanding); the rest of us who pay insurance premiums will.
In that sense, this preserves the Democratic Party role as the party of random wealth transfers. Just imagine that somewhere a self-employed software consultant pulling down several hundred thousand a year has been paying for his child's asthma treatment out of pocket because he can't get coverage. But now he can, thereby leading to an increase in the insurance premiums for everybody else, including Mailroom Mary, who is trying to get by on $25,000 a year. Such a victory for social justice!
How often will that be happening? No one knows! This new rule is not means tested as to beneficiaries and no one is yet eligible for premium subsidies, but Dems are thrilled anyway. Oh, well - they are thrilled with the individual mandate that forces the young and healthy to subsidize the older and less healthy (but often higher paid). Random wealth transfers.
If I had to guess I would imagine that, given the recent expansions in Medicaid and S-CHIP, the beneficiaries of this children fol-de-rol will not be low earners and may include a lot of successful self-employed people. Which is fine.
The WSJ includes this on coverage:
The number of children who would be affected by the broadest interpretation of the law could be relatively small. The Children's Health Insurance Program, a 1997 health-care plan for low-income children, is already credited with extending coverage to about eight million children who are not poor enough for Medicaid and includes rich benefits and low cost sharing.
Roughly eight million children remain uninsured, according to the Kaiser Family Foundation, but just 1% to 2%—or 80,000 to 160,000—have a health condition such as cystic fibrosis or cancer that would disqualify them from private insurance coverage, said Sara Rosenbaum, chairwoman of the health-policy department at George Washington University and a children's health-care expert. Many of those children's families were unaware they could qualify for Medicaid or CHIP assistance or enroll in an employer plan, she said.
"We're talking nationwide about a handful of children" who might benefit from expanded private coverage, Ms. Rosenbaum said. "I can't imagine why insurance companies are fighting this so hard."
It's clearly a losing issue for them, although I do think they had a winning legal argument. And I am still mystified as to how the HHS can write rules that turn the legislation sideways, but I try to learn something new everyday.
FOR THE DEEPLY SKEPTICAL: An alternative explanation is that Team Obama did not want an extended discussion about their inability to draft legislation and insurers did not want an extended chat about their unwillingness to insure sick kids, so a tacit understanding was reached - the HHS will pretend to write something meaningful and insurers will pretend to play along; later, they will lapse back to business as usual and HHS will ignore it.
DEEP SKEPTICISM, CONTINUED: The Politico releases the victory letter from HHS Secretary Sebelius and the unconditional surrender from the insurance group; we applaud the kabuki but are unconvinced.