[Mrfnews] MRF Leaders Report 2 January

[mrf-news at mrf.org]

07LR02 - MRF LEADERS REPORT - January

MRF LEADERS' REPORT
Motorcycle Riders Foundation
236 Massachusetts Ave. NE
Suite 510
Washington, DC 20002-4980
202-546-0983 (voice)
202-546-0986 (fax)
jeff at mrf.org (e-mail)
http://www.mrf.org (website)

#07LR02 - MRF LEADERS' REPORT – January 12, 2007

TO: The Leaders of the American Motorcyclists' Rights Movement HIPAA –
URBAN LEGEND OR DID IT JUST GET WORSE?

The Department of Health and Human Services (HHS) recently printed the
final rule concerning “Nondiscrimination and Wellness Programs in Health
Coverage in the Group Market,” also known as the loophole that allows
health insurance providers to refuse benefits on a claim that was the
result of a motorcycle accident. The final rule is the result of a process
that began almost 10 years ago when the interim rules were published in
1997 as a direct result to the original HIPAA (PL-104-191) legislation
passed by Congress in 1996.

The idea of not delivering on health insurance coverage has it roots in a
much different arena than motorcycles . . . domestic violence. Back in the
early 1970’s in California, health insurance providers began exploiting a
loophole that would become known as the “wife beater clause,” which
essentially allowed insurance companies to not provide repeat coverage for
damage done as a result of a heavy-handed husband. The insurance companies
claimed that they would provide coverage for the initial incident of
domestic violence, but after that they shouldn’t have to because the woman
should have left the abusive husband, thus making the subsequent beatings
her fault and uninsurable. Being 1970 and being California, that loophole
did not last very long, but nevertheless began a troubling trend of
insurance providers using every loophole to excuse themselves from paying
on claims.

This final rule clarifies who exactly can be refused benefits and how many
Americans are affected. The answer in both cases is a lot more than was
previously thought. 135 million Americans are in the group insurance
market, and every one of them can be refused any health insurance funds
under what is called the “sources of injury rule.” The group market makes
up the bulk of the insurance market when compared to the 2.5 million who
participate in individual plans. Basically, if you have insurance through
your job, even if you work for the government, you can be refused coverage
of an injury based simply on the source of that injury and nothing else.

Can my employer do that? The answer is absolutely, if they tell you.
Employers and insurance providers must provide with a full written or
virtual explanation of your insurance plan, and each year after that they
must provide you with an update that tallies any additions or reductions
in material benefits. So if they are going to exploit this loophole, they
simply have to tell you either in the initial book or in the yearly
changes. It may be the fine print, but legally that’s ok.

Now for the real question: is it happening? Are insurance companies really
denying benefits for hospital bills because the injured party was on a
motorcycle instead of in a car? It would seem so, given that the insurance
companies’ inherent greed and the practice of making a profit would
encourage them to refuse claims whenever they had the legal authority to
do so. Just ask any beach house owner in the Gulf Coast right now, and all
you will hear about is the outrageous behavior of the insurance companies
and how nobody is getting a fair market price for property or belongings
lost. Well, it seems that the insurance companies aren’t too preoccupied
with motorcyclists or snowmobilists or any other group of Americans
potentially affected by this glaring loophole. For the past six months I
have been asking for actual examples of individuals who can attest that
they have been singled out for riding and have had to pay hospital bills
out of pocket because they were hurt while doing some riding on a
properly-licensed bike. To date, I have heard from no one. I thought it
was me, so I inquired around some of other folks working on this issue,
including the AMA, and none of the organizations I contacted have heard of
any cases either.

So what’s going on? Do the insurance companies not know of this loophole?
That’s doubtful given the hundreds of lawyers, accounts and actuaries they
employ, many of whose sole mission is to uncover these exact types of
loopholes to save their middle managers a few hundred thousand a year.
Could it be that the insurance companies have some scruples and are not
choosing to exploit bikers? That’s not likely either. In a closed door
meeting I had with some of the original authors of this rule, they
confessed that they think of this loophole as sort of an urban legend.
Very little is known about why the original HIPAA bill included the source
of injury rule, and very little is known about any actual examples of the
rule being used by insurance companies, yet there is a lot of talk about
it around the country. Undeniable is the fact that the loophole does exist
and could one day be used, and if so it would spell the end of
motorcycling as we know it.

One thing this final rule does carve in stone is the need for a
legislative fix. In fact, in that closed door meeting with the folks at
the Department of Labor and HHS they revealed that they, as an agency,
don’t have the legal authority to close this loophole. In fact, if they
did close it they feel that the insurance companies would sue and win,
therefore making any chance at passing a legislative fix all that much
more difficult. This sentiment was originally express by long time biker
turned politico Tommy Thompson when he held the top spot at HHS a few
years back. So I have every reason to believe the rank and file agency
paper pushers are telling the truth.

So we have some work cut out for us in order to close this loophole before
it does become a widespread problem. Legislation is being re-drafted and
will soon be re-introduced in both bodies of Congress. When that happens,
the push will once again resume toward fixing this loophole. However,
Congress is going to want actual examples before they legislate the
insurance industry. Without those examples, we have an uphill battle.
Congress isn’t likely to waste valuable time and resources on something
that may not be a problem right now, as that’s just the shortsighted
nature of our Congress.

So to answer my own question, it just got worse.

You can read the final rule in the Federal Register Volume 71, Number 239.
http://www.gpoaccess.gov/fr/index.html

IN OTHER NEWS . . .

NHTSA recently had a meeting of the Motorcycle Awareness Subcommittee, a
smaller core of individuals that regularly attend the quarterly meetings
held at the safety agency.
This inaugural meeting was attended by yours truly, AMA, MSF, and the
motor vehicle administrators and a host of NHTSA folks. We began with the
intention of addressing motorcycle awareness campaigns and came up with
what NHTSA calls a “planner”. This planner will be a host of templates of
press releases, event ideas, campaign slogans and posters, PSA and other
items geared at promoting “May is motorcycle awareness month.” The planner
will be available this spring for public consumption. The MRF will be
reviewing the proposed planner later this winter and will be able to sign
off on it before it’s revealed. We should all be looking forward to this
helpful tool.

NEWBIE GREENIE

President Bush has tapped Molly O’Neill to serve as the Environmental
Protection Agency’s assistant administrator for the Office of
Environmental Information, replacing Kim Nelson, who left the agency late
last year. O’Neill is currently the state director for the Environmental
Council of States’ National Environmental Information Exchange Network, a
jointly-governed initiative between the EPA and state governmental
agencies that shares and exchanges data over the Internet. Before joining
ECOS, O’Neill was an environmental consultant for 14 years, working on
organizational and performance assessments, measures, business process
re-engineering, and large-scale information management system
implementation projects. She received a bachelor’s degree in biology from
Virginia Tech. In her statement before the Senate Environment and Public
Works Committee, she didn’t mention any radical changes she would like to
see or any other red flags. My guess is it will be business as usual with
the Environmental Protection Agency.

IS DETROIT BACK IN BUSINESS?

The new chairman of the House Energy and Commerce Committee is going to do
everything he can to bring back the glory days of the Motor City. Detroit
is far from the powerhouse it once was, losing countless jobs and dollars
to Toyota and others. Chairman John Dingell (D-MI), a hometown Detroit
boy, is often referred to as the dean of the House, mainly because of his
career as a House member for over fifty years. He just won his 27th term
and is currently the longest-serving member of the House. He has sworn to
defend his automaker constituents, which does seem admirable. However, one
of the ways he plans to breathe new life into the Big Three automakers is
on the backs of the American consumer and the rights of the automobile
owner. Last Congress, Dingell was one of the most outspoken opponents of
the Right To Repair Act. He routinely tried his best to torpedo it in
committee and was often persuasive enough to win the support of his
Democrat allies. Now they are running the committee with Dingell at the
wheel, so don’t expect to see any movement on the Right to Repair Act,
which was HR 2048 in the 109th Congress, or any protection for smaller
independent repair shops that are struggling to exist alongside a massive
dealership network.

Ethics Debate Begins
The US Senate began debate this week on a hot button election issue,
ethics in Washington. S. 1, sponsored by both party leaders of the upper
body of Congress, was introduced on Tuesday and it’s off to the
traditional slow Senate start. Debate is likely to run for a few weeks if
not the whole month of January. Of concern to the grass roots lobbying
community are provisions that have been floated in the past, but never
actual introduced, that would require excessive lobbying activity reports
from every registered lobbyist in the Nations Capitol. By excessive I mean
just plain crazy, including things like reporting to the Clerk of the
House and Senate every email, fax, phone call, personal conversation with
every elected official and staff. Ethics are a good thing and reform is
needed but collecting information just for the sake of collecting is not
only ridiculous it is nearly impossible. It would also induce an
environment in Washington where possibly more mischief would emerge.
Senate support was initially high for some expansion of the data currently
collected from lobbyists but that support has eroded as groups, like the
MRF, have been throwing cold water on the issue. Its difficult to predict
the future of congress, but barring any more high profile lobby scandals,
the ethics reform package that will eventually pass should not have any
adverse effect on how the MRF or any other grassroots political activists
gets things done.

The MRF will continue to keep you updates on issues impacting motorcycling
from the Nations Capitol. -JH

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(c)All Information contained in this release is copyrighted. Reproduction
permitted with attribution. The Motorcycle Riders Foundation, incorporated
in 1987, is a membership-based, national motorcyclists' rights
organization headquartered in Washington, DC. The first motorcyclists'
rights organization to establish a full-time presence in Washington, DC,
the Motorcycle Riders Foundation is the only Washington voice devoted
exclusively to the street rider. The MRF established MRFPAC in the early
1990s to advocate the election of candidates who would champion the cause
of rider safety and rider freedom.
________________________________________

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