April 7, 2001:

The Internet provides us with a lot of information...this is something of great concern that began circulating early last week.  We thought we would post it and ask for your feedback...

DATE: March 22, 2001

RE: Proposed Adverse Rules on Health Insurance Coverage for Riders

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 health-care 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 Portability and Accountability 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 health-care 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 after 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 health-care protection to employees not only involved in illegal activities, like driving a car 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 opposition to this provision. We urge any individual or equine organization to do likewise.

Comments must be submitted by April 9* to:  *DON'T LET A DEADLINE SUCH AS THIS STOP YOU IF YOU WANT TO COMMENT...THE GOVERNMENT WON'T TURN YOURS AWAY IF YOU RESPOND LATER!!!

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:

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