[Vision2020] Underweight Girl Denied Insurance Coverage

[Tom Hansen]

Courtesy of The Denver Channel (an ABC affiliate) at:

http://www.thedenverchannel.com/news/21343449/detail.html

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Underweight Girl Denied Insurance Coverage
Parents Says 2-Year-Old Girl Perfectly Healthy
By Lance Hernandez, 7NEWS Reporter

ERIE, Colo. -- First it was a 4-month-old Grand Junction boy who was
denied health insurance coverage because, at 17 pounds, he was considered
overweight. Now comes word that a 2-year-old Erie girl has also been
denied coverage because she doesn't weigh enough.

Aislin Bates weighed 6 pounds, 6 ounces at birth. She now tips the scale
at 22 pounds.

"She's perfectly healthy, yet she has become a statistic," said Aislin's
mother, Rachel Bates. "There's no reason for her to be a statistic as a
non-insured person."

When Aislin's father, Rob, worked for another company, Aislin was covered
under the company’s group health insurance plan.

Now that Rob is working on his own, he's had to get new insurance. The
company, UnitedHealthcare's Golden Rule, sent the family a letter, which
says in part, "We are unable to provide coverage for Aislin because her
height and weight do not meet our company standards."

"It took me by surprise," said Rob Bates. "I didn't think that her size
was that abnormal and that it was something that you'd consider to be
unhealthy."

"I had no idea that this would be an issue," Rachel Bates added, "because
we always had group insurance with his job. I was floored when a
height-weight standard prevented coverage."

A spokeswoman for UnitedHealthcare's Golden Rule said 89 percent of the
people who apply for insurance get it. Ellen Laden, the company's public
relations director, told 7NEWS that most insurers have their own
proprietary height and weight guidelines.

"Ours are based on several medical sources, including the Centers for
Disease Control, and are well within industry standards," she said.

Laden, who said she couldn't talk specifically about the Bates' case,
added that, "When evaluating height and weight, we typically utilize other
factors as well in making a decision, such as medical records that show
evidence of treatment or any underlying medical conditions."

The Bates say Aislin is undergoing treatment for an active gag reflex.

"It's very minor and she probably will only need therapy for a few more
months," Rachel said.

Rachel told 7NEWS that both the therapist and her pediatrician wrote
letters in support of the family’s quest to appeal the insurance company's
decision. Both stated that Aislin is healthy and continues to grow.

"We would definitely like to see insurance reform," Rob Bates said. "We
are not proponents of universal health care by any means, but what we want
to see is that insurance companies have legitimate reasons for denying
coverage."

State Senator Betty Boyd, D-Lakewood, chairs the state's Health Care Task
Force. She said, "If I were making the decisions, I think I would
certainly cover this child."

Boyd said it behooves insurers to be reasonable when making their decisions.

"If insurers exercise reason, they're less likely to see mandates coming
down the pike."

Laden said, "If a child did not meet our weight guidelines and the child
was treated and continued to show steady growth for several months after
treatment ended, in most cases we would reconsider covering the child."

Laden added that comprehensive coverage is currently available through
Cover Colorado for individuals who don't qualify for health insurance in
the individual market. The Bates said Aislin is temporarily covered
through COBRA, a federal program that allows people to continue an
employer-based health insurance plan for up to 18 months. The parents said
it costs as much to cover Aislin under COBRA as it costs to cover the
remaining three family members.

"You'd never think that something like size, something that seems so
irrelevant to your health, would be a discriminating factor," Rachel said.

In the Grand Junction case, Rocky Mountain Health Plans changed its policy
and now says it won't consider obesity a "pre-existing" condition barring
coverage for hefty infants. The Bates are hoping United HealthCare's
Golden Rule has a similar change of heart.

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The Denver Channel news video

http://www.youtube.com/watch?v=dlgJZqJzdNM

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Seeya round town, Moscow.

Tom Hansen
Moscow, Idaho

"The Pessimist complains about the wind, the Optimist expects it to change
and the Realist adjusts his sails."

- Unknown