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Washington state's insurance commissioner, Mike Kreidler, said "there is no question" that discrimination is creeping back. "The question is whether we are catching it or not," added Kreidler, a Democrat.

´╗┐Groups claim insurance discrimination in new forms

Compounding the uncertainty is that Washington and the states now share responsibility for policing health plans sold to individuals.

More than 300 patient advocacy groups recently wrote Health and Human Converse Dainty Denim Blue Services Secretary Sylvia Mathews Burwell to complain about some insurer tactics that "are highly discriminatory against patients with chronic health conditions and may . violate the (law's) nondiscrimination provisions."

11, 2014, photo, Charis Hill, who has a rare form of arthritis that affects the spine, poses in Capitol Park in Sacramento, Calif. Hill has health insurance under one of the new plans offered through the health care law, could not afford the medication required for her condition because of the plan's high copays. As a result she's has had to get financial assistance from the drug manufacturer. Hill says riding her bike helps manage her arthritic condition. Advocates for patients with serious health problems say that one of the main goals of the new health care law is being undermined. (AP Photo/Rich Pedroncelli)

Affordable Care Act's anti discrimination provisions. Some regulations have been issued; others are pending after more than four years.

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Among the groups were the AIDS Institute, the American Lung Association, Easter Seals, the Epilepsy Foundation, the Leukemia Lymphoma Society, the National Alliance on Mental Illness, the National Kidney Foundation and United Cerebral Palsy. All supported the law.

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Although the federal government is running insurance markets in 36 states, state regulators are still in charge of consumer protection. A few states refuse to enforce any aspect of the law.

Kansas' commissioner, Sandy Praeger, a Republican, said the jury is out on whether some insurers are back to shunning the sick. Nonetheless, Praeger said the administration needs to take a strong stand.

An HHS spokeswoman said the department is preparing a formal response to the advocates and stressed that today's level of consumer protection is far superior to what existed before President Barack Obama's law, when an insurance company could use any existing medical condition to deny coverage.

and which doctors and hospitals are in the network.

"They ought to make it very clear that if there is any kind of discrimination against people with chronic conditions, there will be enforcement action," Praeger said. "The whole goal here was to use the private insurance market to create a system that provides health insurance for all Americans."

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The insurance industry responds that critics are confusing legitimate cost control with bias. Some state regulators, however, say there's reason to be concerned about policies that shift costs to patients and narrow their choices of hospitals and doctors.

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Coverage of expensive drugs tops their concerns.

The advocates also say they are disappointed by how difficult it's proved for consumers to get a full picture of plans sold on the new insurance exchanges. Converse Red Low

The Obama administration turned down interview requests.

Kreidler said the federal government should establish a basic level of protection that states can build on. "We're kind of piecemealing it right now," he said.

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The law also takes away some of the motivation insurers have for chasing healthy patients. Those attracting a healthy population must pay into a pool that will reimburse plans with a higher share of patients with health problems. But that backstop is under attack from congressional Republicans as an insurer "bailout."

With open enrollment for 2015 three months away, the Obama administration is being pressed to enforce the Womens Converse Dainty Trainers

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WASHINGTON Ending insurance discrimination against the sick was a central goal of the nation's health care overhaul, but leading patient groups say that promise is being undermined by new barriers from insurers.

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