Newborn with a heart defect denied health insurance

[Jules]

At birth, Houston Tracy let out a single loud cry before his father cut the cord and handed him to a nurse.

Instantly, Doug Tracy knew something was wrong with his son.

"He wasn't turning pink fast enough," Tracy said. "When they listened to his chest, they realized he had an issue."

That turned out to be d-transposition of the great arteries, a defect in which the two major vessels that carry blood away from the heart are reversed. The condition causes babies to turn blue.

Surgery would correct it, but within days of Houston's birth March 15, Tracy learned that his application for health insurance to cover his son had been denied. The reason: a pre-existing condition.

"How can he have a pre-existing condition if the baby didn't exist until now?" Tracy asked.

New federal legislation that will prevent insurance companies from denying children coverage based on a pre-existing condition comes too late for the Tracys. The legislation, passed by Congress and signed by President Barack Obama this week, won't go into effect until September.

But Houston, who is hospitalized at Cook Children's Medical Center in Fort Worth, needs coverage now.

Without surgery, babies with this condition often die soon after birth, although some may live as long as a year, said Dr. Steve Muyskens, a pediatric cardiologist.

"In his case, we had to intervene in the first days of life," Muyskens said.

The defect

With this condition, oxygen-rich blood goes back to the lungs and oxygen-poor blood goes back to the body, depriving it of oxygen and damaging the heart muscle. Surgery to move the arteries to their normal position is usually done within three to five days of birth. It basically involves swapping the misplaced arteries.

"It sounds simple, but it's complex because you have to move tiny coronary arteries that in a baby are 1 to 2 millimeters," Muyskens said.

Doug and Kim Tracy, who live in Crowley and are self-employed, carry health insurance on their other two children. They said they cannot afford insurance for themselves.

They paid out of pocket for Kim Tracy's neonatal care and the baby's delivery. Doug Tracy said they were told that they could apply for insurance for Houston within 30 days of his birth.

A spokeswoman for Blue Cross Blue Shield of Texas declined to comment but issued a statement saying, "Our policy is that if a family has existing coverage with us, a baby can be added to the contract within 31 days without the need for underwriting to assess the baby's eligibility."

But that's only if the parents have coverage, said the spokeswoman, Margaret Jarvis. Read that with the emphasis on parents.

Lawmaker tries to help

After being contacted by the Tracy family, state Rep. Chris Turner, D-Arlington, said he asked the Texas Department of Insurance if there are provisions that can be used to help the family. He said he has not received a complete answer.

Virtually everyone can agree that no one should be denied health coverage because of pre-existing conditions, Turner said.

Tracy said he was appealing the insurance company's decision.

A five-hour surgery to correct the defect was performed Friday, and Houston is doing well. He is being fed through a tube and must learn to swallow. But he should be able to go home within a couple of weeks, Tracy said.

"He's such a fighter, and the doctors say he's got a lot of spunk," Tracy said. "The nurses nicknamed him 'Little Rocky.'"

Read more: http://www.star-telegram.com/2010/03/25/2068267/crowley-newborn-with-heart-defect.html#tvg#ixzz0jbqXEkOh

Source

I struggled with whether or not to even post this, I started to just add it to the "10 states line up to sue over heath bill" thread.  Since it will probably go down the same road, but it is a different story.. if you guys think it needs merged, then by all means merge it.  Or say so and I'll merge it.

As for this article   

[Sophist]

Yeah, the kid is fucked until 2014, when the bill kicks in and he can be covered.

[haloOfTheSun]

Irock thinks it's constitutional that this baby dies.

[Zylos]

That's just not right... =/

They're practically trying to strangle them with red tape there.

[IAMFORTE]

It seems that everything is about it bieng not right and right :/

what a world ehh

Poor kid, good thing he's okay : D
bad thing his family is screwed mostlikely

[tSwitch]

let's keep the political slander out of this thread please.
who gives a fuck about the healthcare bill right now, and pointing fingers, this is terrible and unfortunately will probably be some kind of scapegoat.

[haloOfTheSun]

let's keep the political slander out of this thread please.
who gives a fuck about the healthcare bill right now, and pointing fingers, this is terrible and unfortunately will probably be some kind of scapegoat.

Why? Other than that there's nothing to say except "Oh how sad, a baby is probably going to die". Babies die all the time, and while sad, doesn't deserve a topic in a forum titled "In the News". The reason this case is special is because of health care, or lack thereof. And considering that is the "news" lately, it seems appropriate to take the discussion down that particular natural path.

[tSwitch]

right I'm just saying we should keep the debate in the debate.

[Jules]

Bumping this cause now it's affecting my family, though not in a way so serious as this poor child.  My sister gave birth to an 8lb 3.2 oz baby boy on March 19.  When he was born, and they examined him, they discovered he had Hypospadias. This isn't a terrible thing, according to the information that the doctor gave us it can be corrected with a surgery.  Her doctor recommends he have this surgery around 9 months.  When he was born, he was immediately added onto her insurance.  Because of this, her insurance went up to $400/month.  This crippled them financially so she started searching around for other policies.  This is when she was informed that Logan wouldn't be covered because he had a "pre-existing condition".  So now they have to decide between staying insured and sinking further in debt.  Or dropping the insurance knowing they'll have to pay for this surgery out of pocket.  The total for the surgery comes to $15,000, according to the hospital/surgeons best estimates.  I've told her that keeping them insured is her best shot, even if she can't afford it.  It's still cheaper than trying to pay for that out of pocket.  The only other option is that they leave him like that.  Even if he does have the surgery, he may have to have more than one in order to correct all the issues he has.  :/  What a mess. 

I really hate insurance companies -.- 

[Roph]

Would be free in the UK

[firerain]

Bumping this cause now it's affecting my family, though not in a way so serious as this poor child.  My sister gave birth to an 8lb 3.2 oz baby boy on March 19.  When he was born, and they examined him, they discovered he had Hypospadias. This isn't a terrible thing, according to the information that the doctor gave us it can be corrected with a surgery.  Her doctor recommends he have this surgery around 9 months.  When he was born, he was immediately added onto her insurance.  Because of this, her insurance went up to $400/month.  This crippled them financially so she started searching around for other policies.  This is when she was informed that Logan wouldn't be covered because he had a "pre-existing condition".  So now they have to decide between staying insured and sinking further in debt.  Or dropping the insurance knowing they'll have to pay for this surgery out of pocket.  The total for the surgery comes to $15,000, according to the hospital/surgeons best estimates.  I've told her that keeping them insured is her best shot, even if she can't afford it.  It's still cheaper than trying to pay for that out of pocket.  The only other option is that they leave him like that.  Even if he does have the surgery, he may have to have more than one in order to correct all the issues he has.  :/  What a mess. 

I really hate insurance companies -.- 

I really hate bigot, bloodthirsty companies.

[Irock]

That's why you should be able to purchase across state lines. Health Insurance companies have nearly become monopolies.

[tSwitch]

That's why you should be able to purchase across state lines. Health Insurance companies have nearly become monopolies.

This too.

That's why we need a way to force prices down, or remove a lot of the stupid restrictions that cause stories like this.