Limits on insurance coverage for AIDS allowed by Court
By Laurie Asseo, Associated Press, 01/10/00
WASHINGTON - The Supreme Court, rejecting allegations of illegal bias, today let an insurance company provide less health care coverage for AIDS-related illnesses than for other conditions under the same policy.
The court, without comment, turned down an appeal in which two HIV-positive men argued that the limit on AIDS coverage violates a federal ban on discrimination against the disabled.
The two Chicago-area men, whose names were not given in court papers, bought health care policies from Mutual of Omaha.
One policy, purchased in 1992, set a $25,000 lifetime coverage limit for AIDS-related illnesses but a $1 million maximum for other conditions. The other policy, purchased in 1997, had a $100,000 limit for AIDS-related illnesses and a $1 million limit for other aliments.
The men sued, saying the limits on AIDS coverage violated the federal Americans With Disabilities Act. The law protects the disabled against discrimination in many areas, including jobs and public accommodations.
The Supreme Court ruled in 1998 that people who carry the HIV virus that causes AIDS are covered by the disabilities law even if they have no visible symptoms of acquired immunity deficiency syndrome.
A federal judge in Chicago ruled for the two men in 1998, but the 7th U.S. Circuit Court of Appeals reversed that ruling.
Mutual of Omaha did not refuse to sell insurance to people infected with the human immunodeficiency virus, the appeals court said, but instead made a coverage decision similar to a furniture store deciding not to sell wheelchairs.
The appeals court said most health insurance policies contain coverage caps. Ruling for the two men would ban coverage caps for diseases classified as disabilities but allow limits on coverage for other illnesses, such as heart disease, it added.
Lawyers for the two men told the justices that the limit on AIDS coverage "presents a classic case of disability-based discrimination." The policy would limit coverage for diseases, such as pneumonia, when they are AIDS-related but would not limit coverage for the same disease when it is not AIDS-related, the appeal said.
Mutual of Omaha's lawyers urged the justices to reject the appeal. They said the insurance firm had not discriminated because it offered them the same coverage given to other customers. Mutual's policies limit coverage for other conditions such as alcoholism, drug addiction and mental illness, the company's lawyers said.
The case is Doe vs. Mutual of Omaha Insurance Co., 99-772.
