ADHD News & Research

Health Care Law Loophole: Insurers Refuse New Coverage for Children With Pre-Existing Conditions

A major cornerstone of the health care legislation President Obama signed last week is aimed at providing coverage for children with pre-existing health conditions like ADHD.

Within six months of Barack Obama signing the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 into law, or by September 23, 2010, insurance companies offering group or individual plans are not supposed to be allowed to deny any child under age 19 coverage based on pre-existing conditions such as attention deficit hyperactivity disorder (ADD/ADHD).

But they may try to skirt this requirement, according to reporting from the Associated Press and the New York Times. The Times explains that while insurers agree that they must provide insurance for children with existing policies with pre-existing conditions, because of ambiguities in the language of the law, they may deny new coverage to children because of a pre-existing condition.

Health and Human Services Secretary spokesman Nick Papas told the AP, “To ensure that there is no ambiguity on this point, the secretary of HHS is preparing to issue regulations next month making it clear that the term ‘pre-existing exclusion’ applies to both a child’s access to a plan and his or her benefits once he or she is in the plan for all plans newly sold in this country six months from today.”

Read the full news reporting from the AP and the New York Times

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