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February 16, 2007

Congressmen Stupak and Kagen Introduce Bill to Fix Insurance Loophole

(WASHINGTON, D.C.) Congressman Steve Kagen, M.D. joined Congressmen Bart Stupak (MI-01) and Michael Burgess, M.D. (TX-26) to introduce a bipartisan bill to stop insurance companies from denying coverage for injuries incurred while snowmobiling and horseback riding, and participating in other recreational activities.

“Snowmobiling is part of our way of life in Wisconsin,” said Kagen.  “Thousands who aren’t lucky enough to live here come here to enjoy the outdoor recreation Wisconsin offers. No one should be denied health insurance benefits simply because they travel by snowmobile.”

The legislation would close a loophole in Health Insurance Portability and Accountability Act (HIPAA) that denies health care benefits for those who participate in legal transportation and recreational activities.  In January 2001, a rule was issued that prohibits health plans and issuers from denying coverage to individuals who engage in certain types of recreational activities, such as skiing, horseback riding, snowmobiling or motorcycling.  However, because of the way the rule was written, it has allowed insurers to deny health benefits for an otherwise covered injury that results from participation in these activities.

“Health insurance companies should not be allowed to discriminate against those who snowmobile,” noted Congressman Stupak. “It simply makes no sense to require an insurer to insure individuals who snowmobile, but then deny individuals coverage for certain injuries incurred while snowmobiling. This legislation would enforce Congress’ original intent and ensure recreational enthusiasts are not discriminated against.”

Because of this loophole, an individual who was injured while skiing or running could be denied health care coverage, while someone who is injured while drinking and driving a car is protected.  Additionally, a plan can exclude coverage for injuries sustained while participating in a recreational activity, even though treatment for those injuries, such as a broken arm, would have been covered under the plan if the individual had tripped in their home. Clearly this is contrary to the intent of the law.

“It is essential that insurers cover those who pay their premiums. It’s wrong for them to discriminate against snowmobilers,” stated Congressman Kagen.  “This legislation plugs a wide open hole in insurance coverage and will assist outdoorsmen everywhere in America.”

“The leadership shown by Congressman Stupak and Congressman Burgess on this legislation is critical as it moves through the House of Representatives,” stated Duane Taylor, Government Relations Specialist for the Motorcycle Industry Council.

Senators Susan Collins (R-ME) and Russ Feingold (D-WI) introduced companion legislation in the Senate.

Curtis Ellis
202 225-5665 (office)


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