Tom Hayes (Tipperary South, Fine Gael)
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Question 220: To ask the Minister for Health and Children her plans in relation to those people over 70 years who will lose their medical cards due to being over the income levels; if an arrangement will be made with health insurance companies to get cover for these individuals; if an arrangement will be made to enable them to be covered for existing conditions rather than waiting for years without insurance cover; if a solution has been reached in view of the judicial decision regarding risk equalisation; and the way the risk equalisation issue will impact on the numbers of older people with private health insurance in terms of the price of their premiums. [38692/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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Following the recent Government decision to withdraw automatic entitlement to a medical card for persons aged 70 and over and to raise the means assessment threshold for persons in that age cohort, it is estimated that approximately 5% (20,000) of persons aged 70 and over will no longer qualify for a medical card.

Persons whose income is above the threshold and whose circumstances are such that it would cause them undue hardship to provide medical and surgical services for themselves may be eligible for a medical card at the discretion of the Health Service Executive.

With regard to private health insurance, under the Open Enrolment Regulations, insurers are entitled to apply waiting periods in respect of health insurance cover. It is a matter for the insurers to determine whether or not they would apply waiting periods to persons who may previously have had cover, gave it up and now wish to renew it. I am aware that insurers are sympathetic in such cases. For example, in the case of the VHI I understand that where a person has a break in cover, it will allow them to renew cover without having to serve any waiting periods arising from the break in cover, provided premiums are paid for the interim period. It is important to note that in the period since the granting of medical cards to all persons aged 70, the number of people in this age group holding private health insurance cover has increased.

On 16 July the Supreme Court found the 2003 Risk Equalisation Scheme to be ultra vires. Other elements of the regulatory framework including open enrolment, lifetime cover and community rating were not affected by the Court's decision. The Government remains committed to sustaining the principle of community rating in the private health insurance market. However, a community rated market which is unsupported by some form of risk equalisation mechanism is not sustainable. I am considering advice provided by the Attorney General, the Health Insurance Authority and the Department's consultant actuaries and will be bringing proposals to Government very shortly. Over 50% of the population choose to buy private health insurance. This level of coverage can be attributed to the fact that health insurance is affordable. It is affordable for all age groups because we have a community rated market. These are the reasons why we are working to maintain community rating across the market as a key principle of the regulatory framework.