Riders Health Insurance At Risk

Regulations proposed by the Internal Revenue Service, the Pension and Welfare Benefits Administration and the Health Care Financing Administration could affect people who enjoy horseback riding (and other forms of recreation) by permitting health insurers to exclude coverage for injuries resulting from riding and other forms of “dangerous” recreation. While the new proposals state that an employer cannot refuse health-care coverage to an employee based on participation in recreational activities, they permit health insurers to deny coverage for injuries sustained in connection with such recreational activities, effectively reaching the same result.

The new regulations were jointly issued by the three federal agencies as interim rules, which means they are effective now. But the public has until April 9 to comment on the proposals and such comments will be considered.

These proposed regulations permit exclusions from health insurance coverage based on activities, including horseback riding, that Congress sought to protect. In 1966, Congress passed the Health Insurance Portability and Accountability Act. As we read this Act, it was intended to prohibit health insurers from denying health coverage based on a worker's pre-existing medical condition or participation in legal recreational activities. The legislative history of the Act states that the law "is intended to ensure, among other things, that individuals are not excluded from health-care coverage due to their participation in activities such as motorcycling, snowmobiling, all-terrain vehicle riding, horseback riding, skiing and other similar activities."

Recreational groups, including the American Horse Council, worked to have that language included in the legislative history of the Act because some employers and insurers were discriminating against recreationalists, leaving them without coverage if they were involved in recreational pursuits. Incidents of discrimination involved the denial of health-care protection to employees not only involved in illegal activities, like driving a car while intoxicated, but also when involved in legal recreational activities, such as those mentioned above.

While the proposed rules prohibit a person from being denied health insurance coverage simply because he or she engages in riding, they also permit an insurer to exclude benefits for injuries suffered while engaged in such activities. This effectively excludes individuals engaged in such activities.

The AHC will submit comments to the federal agencies in opposition to this provision.  They encourage individual or equine organization to do likewise. A sample letter follows--please re-draft it to make it as personal as possible. This will give it more weight. Comments can be emailed to the Department of Labor at HIPAA702@pwba.dol.gov no later than April 9.   

Sample letter:


April X, 2001

U.S. Department of Labor
Pension and Welfare Benefits Administration
200 Constitution Avenue, NW
Room C-5331 - Attention: Nondiscrimination Comments
Washington, DC 20210
Dear Sir or Madam:

We are writing in opposition to the regulations proposed by your agency under the Health Insurance Portability and Accountability Act (HIPAA).

Like tens of millions of other American we enjoy horseback riding.  We participate as follows……  Obviously, if we are unable to purchase health insurance, including benefits coverage, that protects us as we participate in this legal activity, it will affect our continued participation.

These rules will affect more than just us.  An economic study commissioned by the American Horse Council shows that recreational horseback riding has a $23.8 billion economic impact in the U.S., supports 317,000 jobs and involves 3 million horses. This segment of the American horse industry is growing rapidly.  Horse owners, breeders, stables, outfitters, dude ranches, veterinarians and feed and tack stores all rely on the individual rider.  The rules as proposed by your agency will adversely affect this entire industry.

We support the original Congressional intent of the bill, which is to protect individuals like horseback riders from being discriminated against and denied health insurance coverage, including benefits,  simply because they are participating in a legal, recreational activity.  The proposed rules suggest that plans may limit or deny benefits for injuries that result from participation in recreational activities.  This is directly opposite to the intent of Congress. 

We suggest that the proposed rules be amended to provide that if a group health plan generally provides benefits for a type of injury, the plan may not deny benefits otherwise provided for treatment of the injury if it results from participation in horseback riding and other recreational activities.

Thank you for your consideration.


Your Name

About the Author

Stephanie L. Church, Editor-in-Chief

Stephanie L. Church, Editor-in-Chief, received a B.A. in Journalism and Equestrian Studies from Averett College in Danville, Virginia. A Pony Club and 4-H graduate, her background is in eventing, and she is schooling her recently retired Thoroughbred racehorse, Happy, toward a career in that discipline. She also enjoys traveling, photography, cycling, and cooking in her free time.

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