Rejections Increase as Policy Prohibition Nears

Individual rejection rates for pre-existing conditions continued to reach toward one-in-four who apply

August 21, 2009 -- It’s a foregone conclusion these days that if any healthcare reform bill passes Congress this year it will end the practice of rejecting individuals for health insurance coverage because of pre-existing conditions. Until then, insurers are continuing to reject as usual.

In Oregon, despite the inevitable shift in national policy, the percentage of individuals rejected actually increased.

In the second quarter of this year, 4,859 Oregonians were denied individual health insurance policies because of health reasons. Another 15,159 were accepted, amounting to a 24.3 percent rejection rate, based on figures reported by the Oregon Insurance Division.
Considering only Oregon domiciled insurers, which the state has jurisdiction to regulate, the rejection rate was slightly higher at 24.9 percent. These figures do not include 919 Oregonians who found coverage with the state’s high-risk pool, which accepts everyone regardless of pre-existing conditions though premiums are higher.
Denial for health reasons does not include pregnancy, for which 88 other applicants were rejected over the same time period. Another fraction of applicants not included are those denied for other reasons, such as already being covered by an employer, but that number is unknown.

Rejection rates have generally held steady over the past several years, hovering above one in five, but slightly below one in four. The overall rejection rate over the past year was 23.9 percent for Oregon insurers and 22.2 percent for all insurers offering individual plans in Oregon.

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