No corporation can claim a more vital role in passing and starting to implement the health care reform law than WellPoint, which has a larger customer base (34 million) than any other health insurer in the United States. This is not to say that WellPoint supported health reform; quite the opposite. But as President Obama's May 8 radio address demonstrated not for the first time (text, audio), WellPoint is a uniquely maladroit corporate heavy. If it didn't exist, Obama might have had to invent it.
"[W]hen we found out that an insurance company was systematically dropping the coverage of women diagnosed with breast cancer," Obama said in the address, "my administration called on them to end this practice immediately." The company went unnamed, but it was WellPoint, and news of the practice was broken by Reuters in an April 22 news story by Murray Waas, an investigative reporter who also happens to be a cancer survivor. Waas reported that WellPoint
was using a computer algorithm that automatically targeted … every … 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.
This prompted Health and Human Services Secretary Kathleen Sebelius to write WellPoint chief executive Angela Braly and pronounce herself "surprised and disappointed." This practice, Sebelius wrote, was "deplorable." Braly replied that it was she who was "disappointed" that both Sebelius and Waas would "grossly misrepresent" the policies of a corporate citizen in whose Indianapolis headquarters hung "a three-story pink ribbon." Braly referred Sebelius to a fact sheet stating that the computer software in question "is used to look at a series of diagnostic codes meant to capture conditions that applicants would likely have known about at the time they applied for coverage. We do not single out breast cancer or pregnancy."
In other words, WellPoint had a computer program able to identify multiple diseases it found especially conducive to rescission (the routine and disgraceful practice by which health insurers comb through the paperwork of seriously ill policyholders in search of some chicken-shit reason to nullify the policy). Why Braly thought this assertion might improve her company's image is hard to guess. When the smoke cleared, WellPoint had been maneuvered into volunteering to end such rescissions as of May 1, nearly five months ahead of the deadline imposed by the new health law (which prohibits rescissions except when the patient commits fraud or "makes an intentional misrepresentation of material fact"). United Healthcare quickly followed suit.
Read his entire column here.