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Vinehout wants changes to insurance law

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River Falls, 54022

River Falls Wisconsin 2815 Prairie Drive / P.O. Box 25 54022

A longtime advocate of state-funded universal health care, Sen. Kathleen Vinehout, D-Alma, is now pushing for changes in private health insurance.

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The first-term legislator is authoring a bill that she says will put consumer protection into Wisconsin health insurance regulations.

"People want to know when they buy insurance they are really getting coverage they expected," said Vinehout.

In a press release Vinehout notes that a report by the liberal-leaning Families USA gave Wisconsin a failing grade on state consumer protections in individual health insurance.

One of the changes Vinehout wants is to limit insurers to going back only one year to find a pre-existing condition versus the current two years.

The lawmaker notes that 23 other states use a one-year standard.

She also wants the state to adopt an objective standard when determining a pre-existing condition.

This objective standard would allow pre-existing condition exclusions only for medical conditions a person sought treatment for. If the person did not seek treatment for a medical problem insurers could not claim that condition as pre-existing.

She also wants an independent review of all pre-existing denials; however she did not say who would conduct the review.

Another change sought by Vinehout would be to extend the pre-existing exclusion periods for group health policies from 60 to 90 days.

This means that if an individual lost their group health insurance, but picks up another plan within 90 days their pre-existing exclusions would still be good.

Vinehout also wants to require group and individual health care insurers to cover unmarried adult children up to age 27.

Another change Vinehout wants is to allow more access to the state's Health Insurance Risk Sharing Pool.

The HIRSP was created in 1979, and offers health insurance to Wisconsin residents who either are unable to find adequate health insurance coverage because of their medical conditions or who have lost their employer- sponsored group health insurance.

Currently, applicants to the HIRSP must show that they have been denied coverage by two different insurers twice in the past nine months. Vinehout's bill would drop that requirement to just one insurer.

She also wants to give the HIRSP the authority to change the current $1 million lifetime expense coverage.

The Vinehout bill would also require every insurer in the state to report annually the total number of health insurance policies issued in the state and the total number of cancellations and rescissions that were initiated or completed.

Vinehout represents the 31st Senate District which covers portions of Pierce, Clark, Monroe and Eau Claire counties along with all of Pepin, Buffalo, Trempealeau and Jackson counties.

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