Freshman GOP Congressman Upset At Lack of Health Insurance

Newly elected Rep. Andy Harris was aghast when told his health benefits wouldn't kick in until 28 days after his swearing-in.

This is quite amusing.

Republican Andy Harris, an anesthesiologist who defeated freshman Democrat Frank Kratovil on Maryland’s Eastern Shore, reacted incredulously when informed that federal law mandated that his government-subsidized health care policy would take effect on Feb. 1 – 28 days after his Jan. 3rd swearing-in.

“He stood up and asked the two ladies who were answering questions why it had to take so long, what he would do without 28 days of health care,” said a congressional staffer who saw the exchange. The benefits session, held behind closed doors, drew about 250 freshman members, staffers and family members to the Capitol Visitors Center auditorium late Monday morning,”.

[…]

Harris, a Maryland state senator who works at Johns Hopkins in Baltimore and several hospitals on the Eastern Shore, also told the audience, “This is the only employer I’ve ever worked for where you don’t get coverage the first day you are employed,” his spokeswoman Anna Nix told POLITICO.

A couple things I have to note here. First of all, Harris is lucky! In my experience, 30 days is pretty standard in terms of health insurance kicking in on a new job. I know folks who have to wait 60-90 days.

Second, I don’t know what Harris is so worried about. After all, if he’s sick and uninsured, he can always just go to the emergency room, right?

Third, a 30 day gap in health insurance isn’t as scary as it used to be. A few years ago, had Harris gotten sick during this period of time, then gotten coverage, his new insurance company could have claimed that the illness was a “pre-existing condition” and denied any claims related to it or even refused to cover him. That would have left him in a pretty bad spot, because there wasn’t very much private health insurance available for those with pre-existing conditions, and what did exist was prohibitively expensive for most people (even those at a Congressman’s salary).

Had he not mentioned the illness to his insurance company, then required hospitaliziation, the insurance company could have dropped him from coverage altogether on the grounds that he didn’t report the illness upon obtaining coverage.

Fortunately, there have been recent changes in the law which would prevent him being denied claims for pre-existing conditions. Had insurance refused to cover him, there are now high risk pools for those with pre-existing conditions that are affordable with premiums based on the overall population, not just those at high risk. Additionally, had he not disclosed the illness during the 30 day gap, the changes in the law would prevent his insurer from dropping coverage.

I’m sure that Andy Harris is grateful for these recent changes in the law. Right?

FILED UNDER: Campaign 2010, Health Care, US Politics
Alex Knapp
About Alex Knapp
Alex Knapp is Associate Editor at Forbes for science and games. He was a longtime blogger elsewhere before joining the OTB team in June 2005 and contributed some 700 posts through January 2013. Follow him on Twitter @TheAlexKnapp.

Comments

  1. anjin-san says:

    You are not getting it Alex. Harris is one of the important people. The GOP cares about important people. The millions of Americans who don’t have health insurance? Not important.

  2. Michael says:

    A few years ago, had Harris gotten sick during this period of time, then gotten coverage, his new insurance company could have claimed that the illness was a “pre-existing condition” and denied any claims related to it or even refused to cover him.

    This is true for individual plans, but every employer offered group plan I’ve ever had didn’t exclude pre-existing conditions, or even ask about them.

    Surely the new Congressman will have no problem with opting for Cobra coverage during his 28 days, it should only cost him $1,200 or so.

  3. Alex Knapp says:

    This is true for individual plans, but every employer offered group plan I’ve ever had didn’t exclude pre-existing conditions, or even ask about them.

    I had a two year gap in my insurance coverage and when I got a job following, I had to fill out a long questionnaire and provide all of my medical records during that period. I had an ear infection during that time. Then when I got another ear infection and was referred to an ear, nose, and throat specialist, my insurance wouldn’t cover it.

  4. Alex Knapp says:

    Not an issue in any employer group plan I’ve had since, though. I agree. I think that was probably a rare occurance. But it happens.

  5. Andy says:

    The most disturbing thing to me is how he talks about serving in Congress as if it were “employment.”. Just another job I guess?

  6. Tano says:

    “Just another job I guess?”

    Well,,,,yeah. It will be, presumably, his full-time work, and he will recieve a salary for doing it, so yes, it is “employment”. How else would you describe it?

  7. Michael says:

    The most disturbing thing to me is how he talks about serving in Congress as if it were “employment.”. Just another job I guess?

    Why shouldn’t it be?

  8. mantis says:

    What do you expect from the crowd elected by teabaggers who think the federal government shouldn’t be involved in their Medicare?

    Btw Alex, the health care reform law that banned excluding coverage for pre-existing conditions? Mr. Harris won his seat in part by campaigning against it. Here’s his website:

    However, the answer to the ever-rising cost of insurance is not the expansion of government-run or government-mandated insurance but, instead, common-sense market based solutions that ensure decisions are made by patients and their doctors. Reform should focus on reducing costs and maintaining quality while preserving individual rights. I support increased competition, price transparency, tax credits and expanded medical savings accounts, and meaningful medical malpractice liability reform.

    Hey Andy, where’s your medical savings account? That should cover you until your government-run insurance kicks in, right?

  9. Andy says:

    I guess I’m old fashioned in thinking that a Constitutional public office isn’t and shouldn’t be mere employment. Since he is dissatisfied with his compensation he should take the matter up with his boss?

  10. sam says:

    @Michael

    “but every employer offered group plan I’ve ever had didn’t exclude pre-existing conditions, or even ask about them.”

    That’s because the mean, old federal government prevents it.

  11. Michael says:

    sam,
    do you have a reference for that? I thought it was part of the deal between employers and insurance companies, not due to federal regulation (until now, of course).

  12. sam says:

    Sure, see,Pre-existing condition

    Regulation of pre-existing condition exclusions in individual (non-group) and small group (2 to 50 employees) health insurance plans in the United States is left to individual U.S. states as a result of the McCarran–Ferguson Act of 1945 which delegated insurance regulation to the states and the Employee Retirement Income Security Act of 1974 (ERISA) which exempted self-insured large group health insurance plans from state regulation. After most states had by the early 1990s implemented some limits on pre-existing condition exclusions by small group (2 to 50 employees) health insurance plans, the Health Insurance Portability and Accountability Act (Kassebaum-Kennedy Act) of 1996 (HIPAA) extended some minimal limits on pre-existing condition exclusions for all group health insurance plans—including the self-insured large group health insurance plans that cover half of those with employer-provided health insurance but are exempt from state insurance regulation. [my emphasis]

  13. Michael says:

    thanks sam

  14. mantis says:

    the Health Insurance Portability and Accountability Act (Kassebaum-Kennedy Act) of 1996 (HIPAA) extended some minimal limits on pre-existing condition exclusions for all group health insurance plans

    I can tell you from experience, those limits were extremely minimal.

    Under HIPAA, a plan is allowed to look back only 6 months for a condition that was present before the start of coverage in a group health plan. Specifically, the law says that a preexisting condition exclusion can be imposed on a condition only if medical advice, diagnosis, care, or treatment was recommended or received during the 6 months prior to your enrollment date in the plan. As an example, you may have had arthritis for many years before you came to your current job. If you did not have medical advice, diagnosis, care, or treatment – recommended or received – in the 6 months before you enrolled in the plan, then the prior condition cannot be subject to a preexisting condition exclusion. If you did receive medical advice, diagnosis, care, or treatment within the past 6 months, then the plan may impose a preexisting condition exclusion for that condition (arthritis). In addition, HIPAA prohibits plans from applying a preexisting condition exclusion to pregnancy, genetic information, and certain children.

    Basically, if you were treated or had a consultation regarding any medical condition in the six months prior to getting your new group insurance, the insurance company could deny you coverage for that condition. Anyone with chronic or ongoing conditions for which they needed regular medical treatment was basically screwed. This would include a huge number of very common conditions, including cancer, diabetes, HIV, arthritis, carpal tunnel, ulcers, eczema, depression, kidney disorders, high blood pressure, high cholesterol, asthma, heart disease, eye disorders, and on and on and on.

    “but every employer offered group plan I’ve ever had didn’t exclude pre-existing conditions, or even ask about them.”

    They probably did exclude them, and didn’t need to ask about them. They have your medical records. If you had been treated for a condition in the six months prior to getting new insurance, and tried to get treatment for it after enrolling, you probably would have had your claim denied.

  15. Michael says:

    They probably did exclude them, and didn’t need to ask about them.

    They weren’t excluded because we continued the treatment and the treatment was covered by the new insurance.

  16. mantis says:

    They weren’t excluded because we continued the treatment and the treatment was covered by the new insurance.

    Well, then you were lucky in that your new employer’s insurance did not exclude pre-existing conditions, which they could have under the law. Many others were not as lucky.

  17. sam says:

    “Basically, if you were treated or had a consultation regarding any medical condition in the six months prior to getting your new group insurance, the insurance company could deny you coverage for that condition. ”

    Ah, well, I thought the rules were more stringent than that on preexisting conditions. But then, I never had a treatment within the six-months prior time period, etc. BTW, I was never asked for my medical records. How would my employer then have gotten them?

  18. Brian Knapp says:

    This is true for individual plans, but every employer offered group plan I’ve ever had didn’t exclude pre-existing conditions, or even ask about them.

    They exclude ’em but don’t tell you. And really, you don’t know until you try to act on that coverage.

    Letters of Creditable Coverage for any period over 45 days are required as the norm if trying to get coverage for pre-existing conditions on a group plan. If you don’t have that, they don’t have to cover you for not less than one year. Of course, you still have to pay the premiums. Individual plans just won’t cover you.

  19. mantis says:

    BTW, I was never asked for my medical records. How would my employer then have gotten them?

    Your employer wouldn’t have gotten them. Your new insurance company would have. They share records. The patient isn’t involved in that.

  20. sam says:

    “Your employer wouldn’t have gotten them. Your new insurance company would have. They share records. The patient isn’t involved in that.”

    Lovely.

  21. John Personna says:

    There is a national database, and you can request a copy. I did once, and it came back blank for me. On the phone now so I can’t look up a link.

  22. mantis says:

    Yeah, well, it’s been like that for awhile. HIPAA has all sorts of rules for medical professionals and insurance companies to protect your medical info, both from your employer and from others. There have to be methods for doctors to access patient records, and HIPAA defines those methods and procedures.