The broad definition of ‘pre-existing condition’

THE BROAD DEFINITION OF ‘PRE-EXISTING CONDITION’…. In general, when we think about Americans who can’t get health care coverage due to a pre-existing condition, we tend to think of someone with a debilitating disease.

From time to time, it’s important to remember that a much broader understanding of the phrase is more accurate.

A proposal to make preexisting health conditions irrelevant in the sale of insurance policies could help not just the seriously ill but also people who might consider themselves healthy, documents released Friday by a California-based advocacy group illustrate.

Health insurers have issued guidelines saying they could deny coverage to people suffering from such conditions as acne, hemorrhoids and bunions.

One big insurer refused to issue individual policies to police officers and firefighters, along with people in other hazardous occupations.

Some treated pregnancy or the intention to adopt as a reason for rejection.

As Congress and President Obama work on legislation to overhaul the nation’s health-care system, one of their main objectives is to stop insurers from denying coverage on the basis of health status. Proposed legislation would prohibit insurers from denying coverage to individuals with preexisting conditions or charging them higher premiums because of their medical history — practices known as medical underwriting.

One of the documents released yesterday was published in 2003 by an insurer called PacifiCare, which has since been bought by United Healthcare, which mandated “automatic rejection” for all kinds of interesting reasons, including being an “expectant father.” There was also this more general disqualifier: “currently experiencing/experienced within the last 12 months symptoms for which a physician has not been consulted.”

A spokesperson for the parent company said the materials are “outdated.” Asked to provide current underwriting documents, United Healthcare refused. Imagine that.

Also released were materials from a different insurer that denied coverage or charged higher premiums if someone received treatment for toenail fungus. Blue Cross of California guidelines from 2004 included “varicose veins” as a possible disqualifier for insurance.

Remember, as far as opponents of ambitious health care reform are concerned, protecting these insurers is a key and unyielding priority. Subjecting them to competition is deemed outrageous.