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On Reports that WellPoint is Targeting Breast Cancer Patients

April 22, 2010

Reuters is reporting that the insurance company WellPoint is singling out breast cancer patients and “rescinding” their coverage after policyholders become ill:

One after another, shortly after a diagnosis of breast cancer, each of the women learned that her health insurance had been canceled. First there was Yenny Hsu, who lived and worked in Los Angeles. Later, Robin Beaton, a registered nurse from Texas. And then, most recently, there was Patricia Relling, a successful art gallery owner and interior designer from Louisville, Kentucky.

None of the women knew about the others. But besides their similar narratives, they had something else in common: Their health insurance carriers were subsidiaries of WellPoint, which has 33.7 million policyholders — more than any other health insurance company in the United States.

The women all paid their premiums on time. Before they fell ill, none had any problems with their insurance. Initially, they believed their policies had been canceled by mistake.

They had no idea that WellPoint was using a computer algorithm that automatically targeted them and every other policyholder recently diagnosed with breast cancer. The software triggered an immediate fraud investigation, as the company searched for some pretext to drop their policies, according to government regulators and investigators.

Once the women were singled out, they say, the insurer then canceled their policies based on either erroneous or flimsy information. WellPoint declined to comment on the women’s specific cases without a signed waiver from them, citing privacy laws.

That tens of thousands of Americans lost their health insurance shortly after being diagnosed with life-threatening, expensive medical conditions has been well documented by law enforcement agencies, state regulators and a congressional committee. Insurance companies have used the practice, known as “rescission,” for years. And a congressional committee last year said WellPoint was one of the worst offenders.

But WellPoint also has specifically targeted women with breast cancer for aggressive investigation with the intent to cancel their policies, federal investigators told Reuters. The revelation is especially striking for a company whose CEO and president, Angela Braly, has earned plaudits for how her company improved the medical care and treatment of other policyholders with breast cancer.

The disclosures come to light after a recent investigation by Reuters showed that another health insurance company, Assurant Health, similarly targeted HIV-positive policyholders for rescission. That company was ordered by courts to pay millions of dollars in settlements.

Last year, the Energy and Commerce Committee conducted an investigation into problems with the individual health insurance market and found, among other alarming issues, that in the last five years 20,000 individual insurance policyholders have had their policies rescinded by just three insurance companies (Assurant, UnitedHealth Group, and WellPoint). The investigation also uncovered that at least one insurance company, WellPoint, evaluated employee performance based in part on the amount of money its employees saved the company through retroactive rescissions of health insurance policies. Read more findings from the Committee»

One of the breast cancer survivors highlighted in the Reuters article above, Robin Beaton, testified before Congress explaining “the sad thing is Blue Cross gladly took my high premiums and the first time I filed a claim and was suspected of having cancer they searched high and low for a reason to cancel me”:

Americans who are fighting for their lives should not have to fight for their health insurance, which is why the health insurance legislation signed into law last month bans health plans from dropping coverage when people get sick. Speaker Pelosi on today’s news report:

WellPoint's practice of dropping anyone's coverage when they get sick — whether a woman with breast cancer or any other patient — is exactly the kind of insurance company abuse our new health care law prohibits.

Soon every American can be secure knowing that their insurance companies cannot cancel their coverage because of an illness.

And when Republican leaders call for repeal of the health reform law, they are endorsing a return to these abusive policies that have no place in our medical system.

Learn more about the health insurance industry’s practice of rescissions from the Gavel’s coverage of the oversight hearing last year»

Learn more about the insurance reforms, like banning recissions, that take effect this year»