Insurance: New HIPAA correction language introduced

[bigwheel]

While out doing political legwork for IMBA/MORC, Tim Wegner came across some news that is of interest to us. If anyone can shed some light on this, please post.

From Tim:
This new legislation is being introduced to prevent health insurers from denying coverage to someone injured while engaging in "hazardous" recreation. The other e-mail does not mention mountain biking however, we all know that mountain biking is indeed a hazardous recreation. So technically you and I could be denied insurance coverage if injured while riding.

More clarification from Tim:
According to what I have been told. Health insurance companies can refuse to cover your injuries incurred from an accident or crash if the activity is deemed hazardous. Hazardous right now is open to debate. So far though motorcycle, horse, ATV and perhaps some others are considered hazardous. I am sure mountain biking would be considered hazardous as well and your insurance company could decide NOT to cover the expenses for your injury. The bill would stop that type of discrimination.

This is the original messge from Tom Umphress (sorry about the formating):

hen Karen and I were in DC the new HIPAA recreational activities technical corrections bills were introduce in both the Senate and the House. We stopped by Sen. Colman’s office, Sen. Klobuchar’s office, and Rep. Kline’s office on the 27^th . Kline is signing on for sure, Colman has in the past and probably will this time as well, and we are hopping Klobuchar will as well. We sent them follow up notices the other day.

S616 - _http://thomas.loc.gov/cgi-bin/query/z?c110:S.616_:

HF1076 - _http://thomas.loc.gov/cgi-bin/query/z?c110:H.R.1076_:

Let your Senators and Representatives know that the passage of these bills is important to you as a person who enjoys outdoor recreation. Let them know that these bills are an important part of the health of the people in America. Ask them to sign on as a co-sponsor of this legislation. If you do not know who represents you, go to _http://www.house.gov/house/MemberWWW_by_State.shtml#mn_ to find your Representative or _http://www.senate.gov/general/contact_information/senators_cfm.cfm?State=MN_ to find your Senator. Help get this important Legislation passed.

MN information listed below

_Coleman, Norm_ <http://coleman.senate.gov>- (R - MN) Class II
320 HART SENATE OFFICE BUILDING WASHINGTON DC 20510
(202) 224-5641
Web Form: _coleman.senate.gov/index.cfm?FuseAction=Contact.ContactForm_ <http://coleman.senate.gov/index.cfm?FuseAction=Contact.ContactForm>
Picture (Device Independent Bitmap)
_Klobuchar, Amy_ <http://klobuchar.senate.gov/>- (D - MN) Class I
UNITED STATES SENATE WASHINGTON DC 20510
(202) 224-3244
Web Form: _klobuchar.senate.gov/contact.cfm_ <http://klobuchar.senate.gov/contact.cfm>
*Minnesota *
_Bachmann, Michele_ <http://bachmann.house.gov/>, Minnesota, 6th _Ellison, Keith_ <http://ellison.house.gov/>, Minnesota, 5th
_Kline, John_ <http://www.house.gov/kline/>, Minnesota, 2nd _McCollum, Betty_ <http://www.house.gov/mccollum/>, Minnesota, 4th
_Oberstar, James L._ <http://www.house.gov/oberstar/>, Minnesota, 8th _Peterson, Collin C._ <http://www.house.gov/collinpeterson/>, Minnesota, 7th
_Ramstad, Jim_ <http://www.house.gov/ramstad/>, Minnesota, 3rd _Walz, Timothy J._ <http://walz.house.gov/>, Minnesota, 1st

*The American Motorcyclist Association* (AMA) announced that bipartisan bills have been introduced in both the U.S. House of Representatives and U.S. Senate that would end health-care discrimination against motorcyclists, ATV enthusiasts, and participants in other legal recreational activities.
US Representatives Michael C. Burgess (R-Texas) and Bart Stupak (D-Michigan) introduced HR1076, "The HIPAA Recreational Injury Technical Correction Act." On the same day, Senators Susan Collins (R-Maine) and Russ Feingold (D-Wisconsin) introduced identical companion legislation, S 616.
The bills seek to bar employers from discriminating against those who take part in activities such as motorcycling, ATV riding, skiing, snowmobiling or horseback riding in the health-insurance programs they offer their workers.
HIPAA originally prohibited employers from denying health-care coverage based on a worker's pre-existing medical conditions or participation in legal activities, such as motorcycling. But later federal bureaucrats reversed the law, writing rules to allow health-insurance discrimination against motorcyclists and others who engage in legal activities like ATV riding, or horseback riding -- employees were guaranteed the right to health-care coverage, but not guaranteed any benefits under those plans.
Motorcyclists were outraged when federal bureaucrats went against the will of Congress, and the AMA immediately lobbied legislators to right this wrong. Others involved in the effort include the All-Terrain Vehicle Association, the American Council of Snowmobile Associations, the American Horse Council, the BlueRibbon Coalition, the Motorcycle Industry Council, Motorcycle Riders Foundation, and the National Ski Areas Association.
Enthusiasts can send letters of support to members of Congress through the AMA Rapid Response Center at _www.AMADirectlink.com_ <http://www.AMADirectlink.com>.

***Tom Umphress* | Government Relations Officer

[Ish]

hospital: Hi Craig, how did you sustain that concussion and facial fractures?

me: Um, ya I was like walking my dog and like tripped. yea, that's it. Am I covered?

[mn_ultra_guy]

When I read this, I think the insurance companies wants us all to sit home, watch tv, drink bad beer, eat fattening food, and not exercise!

[ebrandel]

When I read this, I think the insurance companies wants us all to sit home, watch tv, drink bad beer, eat fattening food, and not exercise!

Just make sure to "groove your body" at least 3 times a day! Which I think means to go to a doctor's office and dance strangely in front of the receptionist.

[Guest1]

When I read this, I think the insurance companies wants us all to sit home, watch tv, drink bad beer, eat fattening food, and not exercise!

Don't forget pay ever higher premiums every year for the privilege of being insured by them.

[mn_ultra_guy]

It seems like an oxymoron to me, they want to charge higher premiums for smokers, unhealthy people in general, but want to limit what we can do for exercise. I wonder if golf will be consider high risk due to the chance of getting hit with a ball?
Don't forget pay ever higher premiums every year for the privilege of being insured by them.

[bigwheel]

Before we get too riled up, let's find out how they classify mountain biking. If someone knows, please post.

Few of us would disagree that they should charge more for people with unhealthy habits, like maybe smoking or riding motorcycles without a helmet. I don't know how they measure the health benefits of pedaling your bike against the costs that they incur when you crash your bike.

Either way, it appears to be the motorcycle/ATV/snowmobile lobby groups that are lobbying for the new law.

[Nita]

Riding a bike is the second most injury-prone activity for children according to emergency room stats. Half of those deaths are sadly children. But the number one risk is riding in a car. So I suppose walking is the future in either event. Insurance companies make money through premiums and their formula of statistics and probabilities of people making claims, but in the same way, I don't see how insurance companies could figure the many levels of riding a bike. Riding a bike is all-encompassing, too many people do it, it would be very difficult to pass this.

[mn_ultra_guy]

Bob,
I am glad that you do feel riding a motorcycle without a helmet is dangerous, I was kind of worried there.:D
I like the parents who make their kids wear one, but they do not.
Few of us would disagree that they should charge more for people with unhealthy habits, like maybe smoking or riding motorcycles without a helmet.

[JayT]

Before we get too riled up, let's find out how they classify mountain biking.

Agreed.

Each of the mentioned *hazardous* actives have one thing in common. They are not self-propelled.

[jkalla]

Riding a bike is the second most injury-prone activity for children according to emergency room stats. Half of those deaths are sadly children. But the number one risk is riding in a car. So I suppose walking is the future in either event. Insurance companies make money through premiums and their formula of statistics and probabilities of people making claims, but in the same way, I don't see how insurance companies could figure the many levels of riding a bike. Riding a bike is all-encompassing, too many people do it, it would be very difficult to pass this.

Riding in a car may be a higher risk activity than riding a bike - but if you are injured in a car accident the car insurance is the primary insurer, not your health insurance. Your auto insurance rates reflect this by having higher rates for drivers with poor driving records.

If you think it is ok for insurers to charge higher rates for high risk activities such as smoking then why is it not for other high risk activities. It isn't illegal to smoke and it isn't illegal to be overweight. It certainly isn't illegal to have Type 1 diabetes but I know someone who was denied health insurance coverage for having it.

There are people on this website who don't want to be told to wear a helmet, but if your health insurer told you they wouldn't cover your head injury unless you were wearing a helmet - what would you do? How many people think that motorcyclists should be covered if they decide not to wear a helmet? Where do we draw the line?

[Guest1]

I ride motorcycles, alot. Actually not as much as I used to but I doubt anyone on this board would ride as many miles a year as I did.

Point is how many on this forum can say they ride a motorcycle year around or ride in excess of 30k a year on a motorcycle?

Now how many drive a car daily?

Ins. is trying to cut money so that they make more, same as yeti building most of their bikes in Taiwan.

Where is the highest dollar spent in insurance, the last three years of someones life, now I am the devil for saying it, but, if I am going broke I cut where the biggest benifit to me is, not where the money is coming from.

[Heuy]

I would like to see a statistical model that controlled for avid mountain biking. I would think that on average mountain biking lowers one's medical bills. Sure every now and then someone breaks a collarbone, but breaking a bone is not very expensive at all when compared to diabetes, heart disease, etc.

I believe that insurance companies know this, thats why when I bought my own insurance a few years ago it wasn't on the list that would get me denied.

Skydiving.... nope
hang gliding..nope
motorcycling.nope
reckless driving
record.........nope

whew, they didn't ask about jumping off of stuff with your bicycle, I'm good:D

[jzipfel]

I got some short term disability insurance last year, being self-employed thought it was a good idea, and they specifically asked if I currently engaged in hazardous activities. They listed thinks like skydiving, mountain climbing, etc, but no where did they mention mountain biking.

So, I said nope, I don't currently engage in those. Didn't tell them that I would like to get back into mountain climbing. And If they don't list mountain biking, then I'm not asking or telling.

[jkalla]

I ride motorcycles, alot. Actually not as much as I used to but I doubt anyone on this board would ride as many miles a year as I did.

Point is how many on this forum can say they ride a motorcycle year around or ride in excess of 30k a year on a motorcycle?

Now how many drive a car daily?

Ins. is trying to cut money so that they make more, same as yeti building most of their bikes in Taiwan.

Where is the highest dollar spent in insurance, the last three years of someones life, now I am the devil for saying it, but, if I am going broke I cut where the biggest benifit to me is, not where the money is coming from.



Auto insurance rates are affected by how much you drive. That is why they ask you how far your daily commute is. That is also why people lie about it.

Health insurance also costs more for eldery than for young people. If you have health insurance - they can not kick you off but they can raise your rates as you get older.

Insurance rates are not arbitrary - they are based on actuarial tables.

[mn_ultra_guy]

Dan,
Sorry to hijack!
Do you road ride or dual sport? I rode 27945 miles last year on my MC. PM me if you want to chat more. I HATE my car, but I will admit I LOVE my MC as much as I do my bicycles. There is a connection between MC riders and bike riders.
Devin
I ride motorcycles, alot. Actually not as much as I used to but I doubt anyone on this board would ride as many miles a year as I did.

Point is how many on this forum can say they ride a motorcycle year around or ride in excess of 30k a year on a motorcycle?

Now how many drive a car daily?

Ins. is trying to cut money so that they make more, same as yeti building most of their bikes in Taiwan.

Where is the highest dollar spent in insurance, the last three years of someones life, now I am the devil for saying it, but, if I am going broke I cut where the biggest benifit to me is, not where the money is coming from.

[mn_ultra_guy]

You mean like when I hear that riding a motorcycle or even a bicycle kills people? BS, getting hit or crasing while doing these activities is what can kill, not the activity!
Insurance rates are not arbitrary - they are based on actuarial tables.

[toasthaiku]

I would like to see a statistical model that controlled for avid mountain biking. I would think that on average mountain biking lowers one's medical bills. Sure every now and then someone breaks a collarbone, but breaking a bone is not very expensive at all when compared to diabetes, heart disease, etc.



Risky sports cause a tiny portion of what goes on at a hospital. I work at SMDC. Most patients come to the ER for chest, abdominal & pelvic pain, infections, respiratory problems, dizziness, etc. The #1 cause for trauma? Falls - off ladders, on sidewalks, etc. We have an entire ICU for cardiac care. No plans for opening a Damaged Mountain Biker wing.

Common sense says the insurance restrictions are nonsense. That's the problem. Common sense doesn't always apply to health insurance.