Rep. George Miller on preexisting conditions at White House health summit

CQ Transcriptions
Thursday, February 25, 2010; 1:30 PM

We're going to go to George Miller.

And, you know, if you want to respond to specific things that Charles raised or make some more general points.

We'll then go back to a Republican. At some point (inaudible) this discussion, and we're going to have to be a little more discipline in our -- in our time in order to stay on schedule on this section, at some point I'd like Secretary Sebelius, who is not only a former governor, but also insurance commissioner, to address some of the issues that have been coming up around (inaudible) insurance and minimum payments.


BOEHNER: Mr. President (inaudible) we were told what the time limits are.

OBAMA: Well, I'm trying to be flexible...


OBAMA: We've got -- we've got about half an hour remaining for this section. So if (inaudible) can keep their...

BOEHNER: Thank you.

OBAMA: ... points brief.

REID: Mr. President, from the Senate, we have (inaudible) Harkin and Rockefeller respond for the Democrats.

OBAMA: Right. (inaudible) got a list.


MILLER: Well, thank you very much.

This issue of insurance reform is I think where most families intersect with their insurance companies, with the health security of their families. And let's start out with our commonalities.

In the bill that Congressman Boehner, Leader Boehner offered on the floor, he agreed that lifetime caps should be -- should be abolished, that annual caps should be abolished, that young people should be able to stay on their parents' plan to I think it was 25. I think your suggestion, Mr. President, is 26. So there's that kind of -- that kind of commonality there.

MILLER: We think that -- and our bill goes further, and some of the suggestions you've made in the interim since the House and the Senate have passed these bills is that clearly we think that preventative care should not carry a co-pay with it, that we ought to encourage people to get that kind of preventative care for themselves, certainly for their -- for their children.

We allow the health -- the health savings accounts to -- to continue. That's a variation on as my colleague talked about, what they think insurance reform should -- should reflect.

Clearly now, when we see the request in California for a 38 percent increase, in Michigan for 56 percent increase, I think in Maine it's 27 percent increase. You've suggested stronger language than we have in either the House or Senate bill, I think along the lines of what Senator Feinstein has been -- has been talking about in terms of rate review. People are trapped in these systems.

But the one area where there still seems to be disagreement. It was not in the substitute offered by the Republicans when we -- when we were on the floor, and that is this question of preexisting conditions, because this is a real trap for families, either because you find out that you need to go to get care for a disease or an illness, and you may get a checkup and they may discover that you have arthritis. But you didn't disclose you had arthritis, so now that's a preexisting condition and you may lose that policy. You may have to -- you may have to provide more.

And the fact of the matter is, you hate to admit this at my age, but I sit here with two artificial hips, a little bit of arthritis, and I have a kidney stone. I'm dead in that insurance market if I have to switch policies or switch companies or look for another chance.

Now, why should that be? Those hip replacements have been with me for 15 years and I have no trouble, but it's a way of denying me care. And if you -- if you have acne, it's a way of denying you care. The fact that you see from one of the Blue Cross companies here is three pages of things that will keep you out of care, will keep you from changing your jobs. And it goes on and on and on -- (inaudible) back pain will keep you -- a preexisting condition; acne that I mentioned; a cleft palate, we talked about earlier here (inaudible).

So what does that mean when you want to change jobs? What does that mean when you want to start your own company? It means you go without insurance or you pay some policy that has a $5,000 deductible or $7,000 deductible. This is a real issue to American families; 56 million people right now have insurance policies where preexisting conditions could knock them out at any given time. We know that 13 million people were denied coverage over the last three years because of preexisting conditions.

And so now you're trapped. You have a preexisting condition. You can continue maybe -- maybe with that insurance company if you pay more, but you can't go -- you can't shop in the marketplace for another insurance company. You can't go from Blue Shield to Kaiser because you have preexisting condition. You start to see the economic trap and uncertainty that families are confronted with.

Now, the interesting thing was during these negotiations, Senator Dodd and I worked very hard on -- on these issues. Most of the business community signed off on getting rid of these -- of these -- of these preexisting conditions. And I think that that's important for us to understand, that that is what real insurance reforms are.

Should you still be able to charge women more than men? Should you rate based upon gender? To what extent can you rate based upon ages? To where do you -- what's the essential benefit that we're providing? We can all describe that plan that's really inexpensive, but doesn't have any benefits that go with it for families.

And so I think that this is -- this is a very important part of this discussion. I know when I go home in my district, I hear about this from people I represent. I hear about this from my wife when she's talking about our kids and her friends and the people she -- she spends time with, how they struggle with these.

And what we're really talking about is the manipulation to move people around within the insurance market. And yet, you can go to a high-risk pool. So yes, because you have a preexisting condition, because I have two artificial hips, I can go to the most expensive insurance system in the country. I'm not in a high-risk pool, and I'm trapped in that high-risk pool forever.

You can make it a high-risk pool among states. You can make it a high-risk pool among small businesses. You can make it a high-risk pool among large businesses. I'm still trapped in the most expensive insurance because of something that happened to me that I had no control over. I have a cleft -- a child with a cleft palate. I have a child with acne. How can this possibly be?

Now, fortunately in our discussions, as I said, a lot of the business organizations have agreed that these things should be phased out over time. Some can be put in right away. It's not terribly expensive to cover people 18 to 26 and that can be done right away, and we have that commonality.

So I would just hope that we would focus on this issue of what real insurance reform looks like with respect to the impacts on families and individuals as they try to navigate this -- this insurance market.

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