Thursday, February 24, 2011

Why did Hawaii's Governor introduce anti-health consumer legislation?

Right now in Hawaii, almost everyone with health insurance has a right to a local hearing process if their health insurance company doesn't agree with their doctor on what is "medically necessary." Whether you've got insurance through your employer or getting Medicaid through companies like UnitedHealth (Evercare) and Wellcare (Ohana), in most cases HRS 432E-6 gives you the right to a local hearing, complete with attorneys and witnesses, when your health insurer refuses to pay for something your doctor says you need. (Exceptions include federal health plan members, self-insured companies like Hawaiian Tel, Hawaii Pacific Health and a few others.)

The Hawaii Senate Ways and Means Committee is discussing today Senate bill (S.B. 1274) that would deprive all of us of that right. Its silent "companion" bill, S.B. 658, will effectively prohibit anyone from filing any sort of appeal against the decisions made by health insurers by making patients responsible for both their own legal fees and those of the insurance company, even if they win.

Last fall's federal case where Rafael Del Castillo was on one side of the aisle, lined up against fifteen or more lawyers (and staff) from the insurance companies on the other side, is a clear example of why no one will dare file for an appeal if HRS 432E-6 gets repealed. Who but the very richest could comprehend assuming financial responsibility for a $4,000 per day legal case, knowing they have to pay even if the insurance company is found wrong?

These bills, which came out of our new administration, are about as anti-health consumer as you can get. The only folks who are going to benefit are the insurance companies, particularly the two that get guaranteed monthly checks from DHS for $50 million or so, regardless of how much they actually spend on medical services.

Why would the new administration propose legislation that favors health insurance companies so blatantly? Or has no one else recently searched Ho'ohiki for Evercare, United Health and Wellcare?

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About Me

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I'm the mom of a child with disabilities. Hannah's first neurologist said she might never develop beyond the level of a 2 month old infant, and there wasn't anything I could do about it. The brain damage was just too severe. Nine years later, she walks, uses a touchscreen computer and I've just been shown she can learn to construct sentences and do simple math with the right piece of technology. Along the way, I discovered I needed to teach myself what Hannah's rights to services really were. Learning about early intervention services led to reading about IDEA and then to EPSDT. I've been waiting for the Obama administration to realize the power and potential of EPSDT for the medical rights - including the right to stay at home with their families - of children with disabilities. The health reform people talk about long term care, and the disability people talk about education and employment, but nobody is talking about EPSDT. So I am.