Limbaugh falsely claimed House bill “prohibits the sale” of private individual insurance

Written by Matt Gertz

Published

Rush Limbaugh falsely claimed that “page 94” of the recently released House health care bill “prohibits the sale of private individual health insurance policies beginning in 2013.” In fact, the provision at issue states that private individual policies can be sold, but only through the Health Insurance Exchange and subject to its regulations.

Limbaugh: “In 2013, there is no private insurance allowed. The sale of it will be prohibited”

From the October 30 edition of Premiere Radio Networks' The Rush Limbaugh Show:

LIMBAUGH: Page 94, Pelosi plan, prohibits the sale of private, individual health insurance policies beginning in 2013, forcing individuals to purchase coverage through the federal government. 2013, after the 2012 presidential election. In 2013, there is no private insurance allowed. The sale of it will be prohibited.

Bill allows private individual insurance to be sold through Exchange

“Page 94” says individual coverage can be offered, but only through Exchange. According to page 94 of the recently-released House health care reform bill:

(c) LIMITATION ON INDIVIDUAL HEALTH INSURANCE COVERAGE.-

(1) IN GENERAL.-Individual health insurance coverage that is not grandfathered health insurance coverage under subsection (a) may only be offered on or after the first day of Y1 as an Exchange-participating health benefits plan.

Bill provides for grandfathering in of existing plans purchased outside of Exchange under certain conditions. According to page 91 of the bill, “individual health insurance coverage that is offered and in force and effect before” before the bill takes effect can be grandfathered in and sold outside of the Health Insurance Exchange if it meets certain conditions.

SEC. 202. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.

(a) GRANDFATHERED HEALTH INSURANCE COVERAGE DEFINED.-Subject to the succeeding provisions of this section, for purposes of establishing acceptable coverage under this division, the term ''grandfathered health insurance coverage'' means individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met:

(1) LIMITATION ON NEW ENROLLMENT.-

(A) IN GENERAL.-Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1.

(B) DEPENDENT COVERAGE PERMITTED.-Subparagraph (A) shall not affect the subsequent enrollment of a dependent of an individual who is covered as of such first day.

(2) LIMITATION ON CHANGES IN TERMS OR CONDITIONS.-Subject to paragraph (3) and except as required by law, the issuer does not change any of its terms or conditions, including benefits and cost-sharing, from those in effect as of the day before the first day of Y1.

(2) RESTRICTIONS ON PREMIUM INCREASES.-The issuer cannot vary the percentage increase in the premium for a risk group of enrollees in specific grandfathered health insurance coverage without changing the premium for all enrollees in the same risk group at the same rate, as specified by the Commissioner.

Limbaugh previously pushed similar false claim about House Tri-committee bill

Limbaugh advanced false IBD claim that bill would “outlaw individual private coverage.” On the July 16 edition of his radio show, Limbaugh read at length from a July 15 Investor's Business Daily editorial that falsely claimed the House tri-committee health-care reform bill includes “a provision making individual private medical insurance illegal” and “would indeed outlaw individual private coverage.” In fact, the provision to which the editorial referred establishes the conditions under which existing private plans would be exempted from the requirement that they participate in the Exchange.