Opinion ID: 223249
Heading Depth: 4
Heading Rank: 2

Heading: $90 Billion Private Underwriting Costs Problem

Text: Congress also recognized that many of the uninsured desire insurance but have been denied coverage or cannot afford it. Its findings emphasize the barriers created by private insurers' underwriting practices and related administrative costs. Id. § 18091(a)(2)(J). Private insurers want healthy insureds and try to protect themselves against unhealthy entrants through medical underwriting, especially in the individual market. As a result of medical underwriting, many uninsured Americansranging from 9 million to 12.6 millionvoluntarily sought health coverage in the individual market but were denied coverage, charged a higher premium, or offered only limited coverage that excludes a preexisting condition. [14] In its findings, Congress determined that the [a]dministrative costs for private health insurance were $90 billion in 2006, comprising 26 to 30 percent of premiums in the current individual and small group markets. Id. The findings state that Congress seeks to create health insurance markets that do not require underwriting and eliminate its associated administrative costs. Id. The Act requires private insurers to allow all applicants to enroll. 42 U.S.C. § 300gg-1(a). Congress stated that the Act, by eliminating underwriting costs, will lower health insurance premiums. Id.