"Snowmobilers and others participating in legal recreational or transportation activities deserve equal protection under our insurance laws. Given the amount Americans pay for health insurance, they should be assured that they will receive the same coverage and benefits whether they break their arm snowmobiling or from falling down the stairs," Senator Collins said. "The legislation introduced today will close the loophole that allows insurers to deny an individual coverage for an injury resulting from a common, legal recreational activity."
"Wisconsin offers an incredible setting for transportation and recreational activities like motorcycling, skiing and snowmobiling," Senator Feingold said. "People who take pleasure in these and other outdoor activities should not be deterred from enjoying them because of a health insurance loophole. This bipartisan legislation will offer outdoor recreation lovers the protection they deserve."
In January 2001, a rule was issued in accordance with the Health Insurance Portability and Accountability Act (HIPAA) of 1996 that was intended to ensure non-discrimination in health coverage in the group market. That rule 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.
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 would be 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.
The legislation, which passed the Senate last Congress, clarifies that individuals participating in activities routinely enjoyed by millions of Americans cannot be denied access to health care coverage or health benefits as a result of their activities.
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