Mar. 18--Sen. Jay Rockefeller, D-W.Va., and Rep. Joe Courtney, D-Conn., introduced a bill Tuesday that would eliminate pre-existing condition exclusions from health insurance policies.

Called the Pre-existing Condition Patient Protection Act, the bill will stop insurance companies from denying health insurance coverage for chronic health conditions such as diabetes and heart disease.

Currently, health insurance companies can specify uncovered conditions for new policy holders.

In a conference call with The Dominion Post, both lawmakers said the bill was part of President Barack Obama's agenda for health care reform.

"Our system is broke," Rockefeller said. For "people who have preexisting conditions ... [insurance companies] will wipe you off their list. ... The president is furious."

Courtney said in addition to securing coverage for chronic conditions, the bill is a crucial part of economic recovery, as recent job losses mean many Americans may be on their own to pay for health insurance.

"This legislation is really about moving the recovery along," he said.

The current bill stems from both lawmakers' previous work. In 2007, the duo introduced the Pre-Existing Condition Exclusion Patient Protection Act, which sought to restrict insurance providers and employers from excluding individuals from coverage due to protection gaps in the Health Insurance Portability and Accountability Act (HIPAA) of 1996, according to Rockefeller's Web site.

Rockefeller said the new bill would push the effort to the heart of health care reform.

"HIPAA was thought to be a terrific step forward ... but there were a lot of loopholes," he said. "What this bill would do is say everybody gets it. There would be no exclusions everywhere in the country."

Both lawmakers said the change should not hurt the insurance industry, but increase the pot of customers, thereby bringing down the cost of premiums.

"I'm confident this measure is something the market can deal with," Courtney said. "This will expand the market, increasing customers."

But according to David Mathieu, vice president of marketing for The Health Plan of the Upper Ohio Valley -- a West Virginia based health insurance company -- the bill would have some adverse effects on his industry.

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"My opinion: No. 1 -- that will make everyone who has an individual policy rate, the rate will go up 20 to 25 percent," he said.

Mathieu said health insurance companies operate with both group and individual insurance policies, and while HIPAA laws offer some protection for individuals switching enrolled group policies from employers, for example, the same protections do not exist for individual policies.

Mathieu gave a primary reason for the lack of protection on individual policies -- what he calls the "bump and run" move -- as health insurance customers often sign up for policies with the intention of obtaining medical care within the first few months of coverage, then not paying premiums after medical procedures are paid for.

Mathieu also predicted a second scenario that might evolve from the "bump and run" move, in which insurance companies stop offering personal policies and focus solely on group policies.

"It is well-intentioned legislation," he said. "[But] if an insurance company can't break even, they're not going to do it. It's not good business."

Both lawmakers, however, said the insurance industry is set up to pool risk, not to avoid it, and should take on more policies and claims.

"If we're going to have universal health coverage, we've got to get these insurance companies under control," Rockefeller said. "They are in business in order to pay for people who are sick."

Dr. Richard Layne, professor of medicine at WVU's School of Medicine, who also practices general internal and geriatric medicine, said his patients tell him that their options for health care payment are not good, and Rockefeller's effort looks like an attempt to make the market more fair and accessible.

"We do have challenges with access to health care coverage and costs of health care, and this would seem to be one way to address that," he said.

Layne described a spectrum of problems, such as his patients who can't get coverage for specific conditions, patients who could qualify for insurance but could not afford it and patients who have been denied any coverage at all.

As for pre-existing conditions, he said the term is pretty broad because individual insurance companies define them. Those conditions could include anything from hypertension to pregnancy.

He also sees potential for complications, as insurance companies can choose in which states they write policies and may choose to do business in healthier areas of the country.

"Most people would agree that [health care] is a social good," he said. "But trying to blend social good and a market-based approach is complicated."

Jason Butcher, public information officer with the West Virginia offices of the Insurance Commissioner, said he would need more information about the bill before he could comment on it. He did not reply in time for this report.

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