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Wellpoint Targets Breast Cancer–But Not for a Cure

This is what health insurance giant Wellpoint has been doing to women diagnosed with breast cancer:

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.

Murray Waas’ investigation of this outrageous practice focuses on three women. One of them had to wait five months for the double mastectomy required by her aggressive cancer. In that five months, the size of her tumor had more than tripled. Another woman received coverage through her mastectomy and reconstructive surgery, but then was dropped by her insurer as she struggled to recover from a life-threatening staph infection. She was unable to get needed reconstructive surgery for the after-effects of that infection and can no longer work. She had been well-to-do and now lives on food stamps and spends her time looking for charities that will help her with her medical and other bills.

Those are horrific stories, and more horrific because they are not isolated:

The investigation last year by the House Energy and Commerce Committee determined that WellPoint and two of the nation’s other largest insurance companies — UnitedHealth Group Inc and Assurant Health, part of Assurant Inc — made at least $300 million by improperly rescinding more than 19,000 policyholders over one five-year period.

WellPoint itself profited by more than $128 million from the practice, and the committee suggested that the figure might be largely understated because the company refused to provide information about cancellations by several subsidiaries.

This is a massive story—in importance and in detail. Read the whole thing, if you can stand to.

Meanwhile, Health and Human Services Secretary Kathleen Sebelius has sent Wellpoint a letter calling on them to stop.

Tags: Health Care