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Federal Agencies Propose Adverse Rules On Health Insurance Coverage For Riders



Posted April 5, 2001
Regulations proposed by the Internal Revenue Service, the Pension and Welfare Benefits Administration and the Health Care Financing Administration could affect people who enjoy horseback riding (and other forms of recreation) by permitting health insurers to exclude coverage for injuries resulting from riding and other forms of "dangerous" recreation. While the new proposals state that an employer cannot refuse healthcare coverage to an employee based on participation in recreational activities, they permit health insurers to deny coverage for injuries sustained in connection with such recreational activities, effectively reaching the same result.

The new regulations were jointly issued by the three federal agencies as interim rules, which means they are effective now. But the public has until April 9 to comment on the proposals and such comments will be considered.

These proposed regulations permit exclusions from health insurance coverage based on activities, including horseback riding, that Congress sought to protect. In 1966, Congress passed the Health Insurance Protability and Acountability Act. As we read this Act, it was intended to prohibit health insurers from denying health coverage based on a worker's pre-existing medical condition or participation in legal recreational activities. The legislative history of the Act states that the law "is intended to ensure, among other things, that individuals are not excluded from healthcare coverage due to their participation in activities such as motorcycling, snowmobiling, all-terrain vehicle riding, horseback riding, skiing and other similar activities."

Recreational groups, including the American Horse Council, worked to have that language included in the legislative history of the Act because some employers and insurers were discriminating against recreationalists, leaving them without coverage if they were involved in recreational pursuits. Incidents of discrimination involved the denial of healthcare protection to employees not only involved in illegal activities, like driving a care while intoxicated, but also when involved in legal recreational activities, such as those mentioned above.

While the proposed rules prohibit a person from being denied health insurance coverage simply because he or she engages in riding, they also permit an insurer to exclude benefits for injuries suffered while engaged in such activities. This effectively excludes individuals engaged in such activities.

The AHC will submit comments to the federal agencies in oppotion to this provision. We urge any individual or equine organization to do likewise. Comments must be submitted by April 9 to:

CC:M&SP:RU (REG-109707-97)
Room 5226
Internal Revenue Service
P.O. Box 7604
Ben Franklin Station
Washington, DC 20044

U.S. Department of Labor
Pension and Welfare Benefits Administration
200 Constitution Avenue, NW
Room C-5331 - Attention: Nondiscrimination Comments
Washington, DC 20210

Health Care Financing Administration
Department of Health and Human Services
Attention: HCFA-2022-IFC
P.O. Box 26688
Baltimore, MD 21207

A sample letter follows. Please retype it on your stationary and redraft it to make it as personal as possible. This will give it more weight. Send the same letter to each agency. Do not simply send this memo in to the agencie

Dear Sir or Madam:
We are writing in opposition to the nondiscrimination regulations under the Health Insurance Portability and Accountability Act (HIPAA) proposed by your agency in January.

Like tens of millions of other Americans we enjoy horseback riding. We participate as follows... Obviously, if we are unable to purchase health insurance that protects us as we participate in this legal activity, it will affect our continued participation.

These rules will affect more than just us. An economic study commissioned by the American Horse Council shows that recretional horseback riding has a $23.8 billion economic impact in the U.S., supports 317,000 jobs and involves 3 million horses. This segment of the American horse industry is growing rapidly. The rules your agency proposes will adversely affect this entire industry.

We support the original Congressional intent of the bill, which is to protect individuals like horseback riders from being discriminated against and denied health insurance coverage simply because they are participating in a legal, recreational activity. We urge you to change the proposed rules to ensure medical coverage, including benefits, for injuries that may occur while riding and engaging in other legal, recreational activities.

Thank you for your consideration.

Sincerely,

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