High-risk pools early test for health overhaul

Fri Aug 13, 2010 6:15pm EDT
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By Jon Lentz

WASHINGTON (Reuters) - When James Howard was diagnosed with brain cancer in March he did not know how he would pay for radiation treatments costing $87,000 and $2,300 a week for chemotherapy.

At the time of his diagnosis, Howard was insured by UnitedHealth Group Inc, a policy for which he paid because his employer, Hennessey Performance near Houston, Texas, did not provide healthcare insurance for its employees.

After his diagnosis, UnitedHealth revoked Howard's policy on the grounds that his was a pre-existing condition.

UnitedHealth said on Friday that Howard had failed to disclose an earlier initial diagnosis suggesting potential cancer from brain scans before he applied for coverage.

A Texas high-risk insurance pool would have paid for his treatments, but only after a year.

Howard, a 28-year-old auto salesman, feared that his prognosis of just over a year to live might be cut short.

"Man, I felt like I was done," said Howard. "There was my death sentence right there."

Then he learned that he was eligible for another high-risk insurance pool created by healthcare reforms passed earlier y this year specifically for people with pre-existing conditions. He applied for enrollment in July when it opened.   Continued...