The "Uninsurables"

insurance woes - keteyian CBS

With 46 million Americans living without health insurance, thousands of uninsured people who can't get insurance contact call centers every month.

Scott Svonkin, an active 41-year-old, never thought he'd be one of them.

"Pacificare rejected me because I'm an expectant father. Blue Shield rejected me because I got a spider bite. And then this one rejected me because of asthma," Svonkin said.

Svonkin has managed his asthma for more than 20 years with $150 a month in medication, making him one of the new "Uninsurables" — people who've been denied individual health insurance, but not for a serious illness, CBS News chief investigative correspondent Armen Keteyian reports.

"I'm the new poster child, or the poster man, for the uninsured in America," he said.

A two-month CBS News investigation exposes a system stacked against the individual. Unlike group plans provided by employers, individual insurers can pick and chose their customers, creating guidelines designed to deny coverage for the most common of health problems.

Acne, asthma, athlete's foot, allergies — and that's just the A's. How do you explain that?

"Our members very much want to get and keep customers," Susan Pisano, vice president of communications at the Association of Health Insurance Plans told Keteyian.

The argument from the other side is that they're cherry-picking the healthiest people, and people even with the most minor problems are being excluded?

"Conditions that seem minor to me and you entail a level of expense that is fairly substantial," Pisano said.

Last year one nationwide survey, the Commonwealth Fund, found that 89 percent, or 52 million, of those looking for individual health insurance didn't get it because it was too expensive or they were turned down.

"Insurers are getting double the profit that they make in the group market. Why is it so lucrative? Because they exclude anybody and everybody who has even a remote sense of risk associated with their health care," says Dr. Bryan Liang, who has studied the insurance industry for more than a decade.

One individual application asks: Have you ever had a headache? Have you ever had an infection? Have you ever had muscle pain?

"They want to know everything about you. Your credit history," for example, Liang said. "Your credit history is something that is very interesting to them, and they to know about it."

It's not just your credit history, but your driving record and the sports you play.

Insurers find all that information — and much more — in a massive, little-known data base called the MIB, or Medical Information Bureau. Insurers have even been known to question "friends and neighbors" about "morality and lifestyle" — using all of this information to decide who they will cover and who they won't.

"They can check your morals and your lifestyle?" asks Keteyian.

"Exactly," says Liang. "And they are going to judge you on this."

If you have any problem whatsoever, you are on the outside looking in — in the individual market.

"One of the things that you are saying essentially is the perception," said Pisano.

But it's a reality for millions of Americans as well.

"Maybe the perception and the reality are a little different," Pisano conceded.

Not for Svonkin. Ironically, he's a member of Los Angeles County's Insurance Commission.

"I never imagined it would be so hard to get health care," Svonkin said. "It's not a matter (that) I can't afford it. It's a matter that they won't give it to me at any price."

All of which has left the new face of the "Uninsurables" with nowhere to turn but a state-run program for high-risk people offering minimal coverage — for $528 a month.



For more information about finding insurance as an individual, see our FYI.
  • Christine Lagorio

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