Portable health insurance has a chance of becoming law

Staying Ahead

March 04, 1996|By Jane Bryant Quinn

NEW YORK -- There's one health care reform that both political parties supposedly agree on. You shouldn't lose your health insurance just because you change your job.

Whether Congress will guarantee this, however, remains to be seen. Republican Sen. Nancy Landon Kassebaum of Kansas and Democratic Sen. Edward M. Kennedy of Massachusetts crafted a bipartisan fix last year that has majority support. But opponents blocked the bill for months, by putting secret "holds" on its progress.

Not until some embarrassing publicity broke about these holds did GOP presidential candidate Sen. Bob Dole of Kansas promise to bring the reform proposal to the floor -- probably in April or May.

But even if it passes the Senate, the outlook is dicey in the House.

Republican Rep. Marge Roukema of New Jersey introduced a similar version of the Senate bill in January. But it's competing with a minimalist bill (reflecting what health insurers want) promoted by Republican Rep. Bill Thomas of California. What's more, many Republicans don't want a health-reform bill to pass before November, lest it give President Clinton bragging rights.

For the flavor of this position, I give you Sen. Rod Grams, the Minnesota Republican, one of the handful of senators who had been blocking the bill. He claims to support the general idea, but says that it shouldn't come to a vote "at a time when the federal government has much unfinished business left on its plate."

The time may not yet be right for Senator Grams, but it's well past time for the tens of thousands of Americans immobilized by "job lock." That's what it's called when you decline new and better opportunities for fear of losing your health insurance.

You're "locked" if you or a member of your family has a medical condition. You could take a new job, but that company's health plan might not cover that particular illness for one or two years -- and maybe never. One family member might be rejected for health care entirely.

You can lose your benefits even without switching jobs. Your company might change health plans; the new plan might not take a worker with high medical bills.

If you quit or are fired, and your company employs 20 or more people, you're entitled to stay in the group plan for up to 18 months, at your expense (that's known as COBRA coverage). If you don't have a new plan by then, however, there may be no way to get decent individual coverage.

Some states have passed laws to mitigate some of these problems. But there are limits to what states can do.

Below, I've listed briefly what the Kassebaum-Kennedy bill would do for employees who quit, or are fired from, jobs where they had group-health insurance. When the politicians come looking for your vote this year, you might ask where they stand on the need for portable health insurance. The Senate proposals:

* If you got a new job with a firm that offered health insurance, DTC you'd have to be taken into the plan as long as you'd had 12 months of coverage at your old firm. The same would be true for your dependents. The new plan couldn't refuse to cover pre-existing illnesses.

* If your new job didn't provide health insurance, any insurer would have to sell you individual coverage -- regardless of your or your family's health -- as long as you previously had group coverage for at least 18 months. However, you'd have to exhaust other options first. That means taking the COBRA plan, if you're eligible, or going onto your spouse's plan.

* Insurers would have to sell group insurance to any company that wanted it. They couldn't refuse small companies that had, say, an employee with cancer, or limit that employee's coverage. They'd also have to stop discriminating against businesses that they think produce too many claims.

There's more, but I'm running out of space. The Health Insurance Association of America (HIAA) doesn't mind guaranteeing you coverage when you move from one group plan to another. But it's dead against guaranteeing you individual coverage if your new employer doesn't have a plan (Representative Thomas' minimalist bill leaves this provision out).

The HIAA is hollering that guaranteed individual coverage would raise health insurance premiums by 10 percent to 20 percent in the first year alone.

"No way," the American Academy of Actuaries (AAA) told my associate, Kate O'Brien Ahlers. The AAA estimates premium increases of zero to 5 percent over three or more years.

The Kassebaum-Kennedy bill won't help people who can't afford their own coverage nor people who are currently uninsured. But it's a good starting place. That is, if Congress cares at all.

You can write to Jane Bryant Quinn at: Newsweek, 444 Madison Ave., 18th floor, New York, N.Y. 10022.

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