Proposed Law Would End Health Insurance: Kayla Kjelshus’s first kid spent seven days in the neonatal intensive care unit, or NICU after she gave birth. A financially traumatic experience followed this traumatic medical experience. Kjelshus and her husband, Mikkel, were faced with an unexpected bill of more than $200,000 for the NICU stay due to an obscure health insurance clause known as the “birthday rule.”

For Charlie Kjelshus, "the birthday rule" meant that dad Mikkel's plan ― with a high deductible and coinsurance obligation ― was deemed her primary coverage after her NICU stay as a newborn. Mom Kayla's more generous plan was considered secondary coverage. This left her parents with a huge bill.
Image Credit: WKAR

New parents may be spared this kind of financial anxiety seven months after KHN and NPR broadcast a report about the Kjelshus family’s experience if lawmakers enact a bill that would offer parents more control when it comes to choosing a health insurance policy for their child.

The birthday rule would be abolished under the new proposed legislation. When both parents have coverage, this regulation governs how insurance companies choose the primary insurer for a child: the parent whose birthday falls first in the calendar year covers the new infant with their plan initially. The insurance carried by Mikkel, whose birthday is two weeks before his wife’s, was primary for the Kjelshuses of Olathe, Kansas, even though his coverage was far less substantial and based in a separate state.

Mikkel Kjelshus stated, “It’s an out-of-date policy.” “Today, both parents are usually required to work in order to make ends meet.” Two jobs generally imply two health insurance options, and while this should be a good thing, in theory, it can lead to a bureaucratic nightmare like the one the Kjelshuses experienced.

Rep. Sharice Davids, D-Kansas, has introduced the “Empowering Parents’ Healthcare Choices Act,” which would eliminate the birthdate requirement and a “coordination of benefits policy” that tangles first-time parents when it comes to enrolling a new infant in insurance.
“I realised there had to be a way to help when I learned about the Kjelshus family’s tale,” Davids said. “When it comes to their new baby’s health care coverage, parents should have the last say.”

The birthday rule meant Charlie Kjelshus’s father’s plan, a $12,000 deductible, a high coinsurance requirement, and a network-based in a separate state, was deemed her primary coverage. Her mother’s more lavish idea was a distant second. Confusion over the two plans resulted in a tangle of red tape for the family that took nearly two years to resolve and drew national attention.

According to Lee Modesitt, director of public affairs for the Kansas Insurance Department, this model law was created by the National Association of Insurance Commissioners and approved by most states, including Kansas. It’s an arbitrary rule that could be fairer if all jobs had identical healthcare coverage. However, in many households, one partner’s plan is far more generous than the other’s.

The news that reform has been proposed “feels fantastic,” Mikkel Kjelshus stated. “We didn’t want anything like this to happen to anyone else.”

Before gaining the president’s signature, the law would need to pass both the House and Senate. Davids was elected to Congress in 2018, unseating a Republican who had held the seat in Overland Park, Kansas, for a decade. She was re-elected in 2020 and represented Kansas’ House delegation as the only Democrat.

Ellie Turner, a spokeswoman for the congresswoman, said Davids is in talks with House colleagues to gain more support.

In an email, Turner stated, “It’s becoming evident that the Kjelshus family is not alone in this experience.” “We’ll keep working to raise awareness and build momentum for a birthday rule reform because every family deserves a say in their child’s health,” she says.

As they prepare for the birth of their second child, the Kjelshus family has a better understanding of how health insurance will operate this time. They feel prepared, just like they did the first time.

“We have the crib. We’ve got everything you’ll need for a baby. This time around, there’s a lot less stress “Mikkel Kjelshus expressed himself. “We have a good idea of what we’re doing.”

Source Link

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.