Environment & Health

Get Breast Cancer; Lose Health Insurance

Thanks to Lucinda Marshall at Feminist Peace Network for pointing us to an amazing, if demoralizing, Reuter's investigation into WellPoint, which provides coverage to 37 million Americans, more than any other single provider. It turns out that WellPoint and its subsidiaries concocted an algorithm that automatically triggers a fraud investigation into any policyholder diagnosed with breast cancer.

Here's the crux of Murray Waas's findings:

The women paid their premiums on time. Before they fell ill, neither 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.

Waas did another similar investigation last month into Assurant Health, which has pulled a similar stunt, canceling the policies of anyone who tested HIV positive.

The dark punchline here is, as Waas points out in his WellPoint piece, “many critics worry the new [federal health care reform] law will not lead to an end of these practices.”

About the reporter

Esther Kaplan

Esther Kaplan

Esther Kaplan is a radio and print journalist and editor of the Investigative Fund at The Nation Institute. She has written for The Nation, The American Prospect, In These Times, The Village Voice, and other publications.


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