Federal investigators have told Reuters that WellPoint, the country’s largest insurance company, is using an algorithm to target women with breast cancer for the express purpose of dropping their coverage.
Murray Waas writes that WellPoint “specifically targeted women with breast cancer for aggressive investigation with the intent to cancel their policies”:
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.
Wellpoint claims that these women had made material misrepresentations in order to justify dropping them. The House bill would’ve allowed them to apply to an “independent external third party” for review before being dropped, and the insurance company would be required to keep their coverage in place until the third party review board made their determination. However, those provisions were removed in the Senate Finance Committee bill, which was included in the final health care bill.
According to Murray, WellPoint lobbyists “helped quash proposed provisions that would have required a third party review of its or any other insurance company’s decision to cancel a customer’s policy.”
As Marcy Wheeler reported last year, the Senate Finance Committee bill was written by former WellPoint VP Liz Fowler, who left her position at the insurance company in February 2009 expressly for the purpose of helping the committee to draft the health care bill:
And when Max Baucus did a “victory lap” after the bill’s passage, he expressly thanked Fowler for her work:
I wish to single out one person, and that one person is sitting next to me. Her name is Liz Fowler. Liz Fowler is my chief health counsel. Liz Fowler has put my health care team together. Liz Fowler worked for me many years ago, left for the private sector, and then came back when she realized she could be there at the creation of health care reform because she wanted that to be, in a certain sense, her profession lifetime goal. She put together the White Paper last November–2008–the 87-page document which became the basis, the foundation, the blueprint from which almost all health care measures in all bills on both sides of the aisle came. She is an amazing person. She is a lawyer; she is a Ph.D. She is just so decent. She is always smiling, she is always working, always available to help any Senator, any staff. I thank Liz from the bottom of my heart. In many ways, she typifies, she represents all of the people who have worked so hard to make this bill such a great accomplishment.
Susan Bayh, wife of Indiana Senator Evan Bayh, is on the WellPoint board. Bayh threatened to join Joe Lieberman in a filibuster of the health care bill if a public option was included, something that would very much threaten WellPoint profits — which have soared in the past year. Susan Bayh’s compensation for her role on the WellPoint board includes valuable stock options.
The fact that the health care bill was written by WellPoint for the benefit of Wellpoint is bad enough. The fact that Max Baucus celebrates this is worse. And the fact that WellPoint jammed the bill through with the help of Evan Bayh, who is adding to his personal fortune at the expense of breast cancer patients, is absolutely despicable.