Most states — including Missouri and Kansas — don’t protect consumers from abuses by health insurance companies, according to Families USA.

The consumer advocacy group released a report Thursday spotlighting problems in the individual health insurance market, as opposed to group coverage offered by employers. The individual market is drawing heightened attention because employer-sponsored coverage is declining and politicians such as Republican presidential candidate John McCain advocate more individual coverage.

In a teleconference, Families USA executive director Ron Pollack characterized the individual health insurance market as the “wild, wild West” for consumers.

“It is a market with many insurance company abuses and far too few state insurance protections,” Pollack said. “The federal government should establish some meaningful protection.”

Families USA said Kansas and Missouri were among the states that don’t require insurers to sell coverage to all applicants, don’t prohibit higher premiums because of health status and don’t put a time limit on coverage exclusions for pre-existing conditions.

Michelle McCoy, a Kansas City area social worker, said individual coverage is out of reach for most uninsured persons. She said she had been denied coverage in the past because of a pre-existing medical condition.

“If you’re working a part-time job, you’re worried about putting food on the table,” McCoy said. “The last thing (you) want to do is fight a battle with an insurance company.”

Emily Kampeter, a spokeswoman for the Missouri Department of Insurance, Financial Institutions and Professional Registration, said about 10 percent of Missourians are insured through the individual market.

“Our state and national insurance system is based on an employer benefit system,” Kampeter said. “If policy-makers want to move toward an individual system, there are going to have to be federal and state law changes.”

Kampeter added that requiring health insurance companies to offer coverage to all applicants probably would result in higher premiums for everyone.

Bob Hanson, a spokesman for the Kansas Insurance Department, said about three out of 10 Kansans with health insurance have individual coverage.

Hanson said it would require changes in state insurance statutes for Kansas to make significant reforms in the individual market.

“Individual health market reforms need to be considered very carefully,” Hanson said. “Guaranteeing coverage and limited rating based on health often lead to problems within the market. For example, some states who have guaranteed coverage guidelines have lost companies who write health insurance.”

Both Kansas and Missouri offer “high risk” insurance coverage for persons who are denied individual coverage. But high-risk policies can be expensive and carry their own restrictions.

For example, patients with pre-existing conditions may have to wait up to 12 months for coverage of those conditions under the high-risk plans offered by the Missouri Health Insurance Pool, Kampeter said.

“We see a lot of people with pre-existing conditions who cannot get individual coverage, and many who could not afford the coverage if they could find it,” said Sheri Wood, executive director of the Kansas City Free Health Clinic. “Because many people don’t get treatment as early as would be optimal, they’re much sicker when they do seek care. This makes their care much more involved and difficult for them, and more costly for the entire health system.”

Consumers can find more viable options if they shop around, said Mike Bukaty, president of Leawood-based Bukaty Cos., an employee benefit and insurance brokerage firm.

“One company may consider something a pre-existing condition and another company may not,” Bukaty said.

Bukaty also recommended using an insurance broker to find the best deal possible when shopping for individual coverage.

To reach Julius A. Karash, call 816-234-4918 or send e-mail to jkarash@kcstar.com.