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Feds, insurance companies spar over health insurance coverage stats Posted: October 4th, 2011

By Maryalene LaPonsie

When it comes to medical insurance, the federal government says one in five Americans are turned down for the coverage they need. The findings were published by the Department of Health and Human Services (HHS) and based upon data provided by health insurance companies for the first quarter of 2011.

According to the HHS, the denial rate regularly exceeded 20 percent and most of those denials came as a result of medical underwriting in which an insurer reviews an applicant's health history and status. While the average denial rate was 19 percent, a quarter of insurer's had denial rates in excess of 40 percent. Another quarter of health insurance companies reported denial rates below 15 percent.

America's Health Insurance Plans, an industry group, argues the government data is misleading. Specifically, the group says HHS did not take into consideration situations in which an individual may be denied for one plan but offered a different medical insurance option instead. Other denials may occur when an applicant does not live within a health insurance plan's coverage area.

Young adults pick up health insurance coverage

Meanwhile, the Obama administration can point to the success of one aspect of its Affordable Care Act. A provision of the health care reform law went into effect last fall to allow young adults to remain on their parent's health insurance plans until the age of 26. Young adults have traditionally made up a significant portion of the uninsured population. Some speculate this may be because young adults generally are not yet eligible for jobs that offer health benefits and affordable health insurance is difficult to find on the individual market.

According to a Gallup poll, nearly 1 million young adults have found medical insurance coverage since last fall. Previously, 28 percent of 18- to 25-year-olds were uninsured. That percentage dropped to 24.2 percent by the summer of 2011. Data from the National Center for Health Statistics recorded a similar drop. The center found the number of uninsured aged 19 to 25 dropped from 10 million last fall to 9.1 million during the first three months of 2011.

The requirement for health insurance companies to cover young adults on parental health insurance plans is just one provision of the ACA that is creating a sweeping overhaul of the U.S. health care system. The greatest test of the law will come in 2014 when all residents will be required to maintain health insurance coverage.