Today, U.S. Congressmen Michael C. Burgess, M.D. (TX-26) and Bart Stupak (MI-01) introduced bipartisan legislation to stop insurance companies from denying coverage for injuries incurred while participating in certain legal recreational and transportation activities, such as snowmobiling and horseback riding.

“Texans have the luxury to enjoy our vast State and all of the outdoor activities it has to offer,” commented Congressman Burgess. “No one should be denied health insurance benefits because they prefer to drive a motorcycle through the Hill Country. It is essential to provide health care benefits to those who have slipped through the loophole by protecting their access to substantive health care.”

The legislation would close a loophole in Health Insurance Portability and Accountability Act (HIPAA) that denies health care benefits for those who participate in legal transportation and recreational activities. In January 2001, a rule was issued that was intended to ensure non-discrimination in health coverage in the group market. That rule prohibits health plans and issuers from denying coverage to individuals who engage in certain types of recreational activities, such as skiing, horseback riding, snowmobiling or motorcycling. However, because of the way the rule was written, it has allowed insurers to deny health benefits for an otherwise covered injury that results from participation in these activities.

“Health insurance companies should not be allowed to discriminate against those who snowmobile,” noted Stupak. “It simply makes no sense to require an insurer to insure individuals who snowmobile, but then deny individuals coverage for certain injuries incurred while snowmobiling. This legislation would enforce Congress’ original intent and ensure recreational enthusiasts are not discriminated against.”

Because of this loophole, an individual who was injured while skiing or running could be denied health care coverage, while someone who is injured while drinking and driving a car is protected. Additionally, a plan can exclude coverage for injuries sustained while participating in a recreational activity, even though treatment for those injuries, such as a broken arm, would have been covered under the plan if the individual had tripped in their home. Clearly this is contrary to the intent of the law.

“The AMA is excited by the opportunity to work with the great staffs of Representatives Burgess and Stupak, as well as the Energy & Commerce Committee’s Subcommittee on Health to close this loophole once and for all,” stated Edward Moreland, Vice-President of the American Motorcyclists Association (AMA) on the HIPAA Recreational Injury Technical Correction Act.

“The leadership shown by Congressman Stupak and Congressman Burgess on this legislation is critical as it moves through the House of Representatives,” stated Duane Taylor, Government Relations Specialist for the Motorcycle Industry Council.

Burgess and Stupak both serve on the House Energy and Commerce Committee, which has jurisdiction over health care issues. Last Congress, 94 Representatives co-sponsored the legislation. Senators Susan Collins (R-ME) and Russ Feingold (D-WI) introduced companion legislation in the Senate.