Crowley, Texas - Newborn Baby Denied Insurance Due To Heart Defect

[Obama 2012 1,714]

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

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 #######," Tracy said. "The nurses nicknamed him 'Little Rocky.'"

[alex and astrid 38]

That's so messed up. Way to go health insurers, try and destroy a newborn baby's life. If stories like this aren't a good reason for universal healthcare, I don't know what is.

[Mr. Big Dog 10,747]

That's so messed up. Way to go health insurers, try and destroy a newborn baby's life. If stories like this aren't a good reason for universal healthcare, I don't know what is.

You see, in the view of some, the baby - or his parents - ought to take personal responsibility for the condition the infant is in and earn his privilege to receive the necessary care to live. It's not like the baby has a right to live once he left the womb.

[Obama 2012 1,714]

You see, in the view of some, the baby - or his parents - ought to take personal responsibility for the condition the infant is in and earn his privilege to receive the necessary care to live. It's not like the baby has a right to live once he left the womb.

It's obvious from the article the parents couldn't really afford the child to begin with, so what the hell they are doing having a third child, when they can't even afford to take care of themselves, is beyond me.

Edited March 27, 2010 by Paul and Vanessa

[Empress of Groovy 373]

It's obvious from the article the parents couldn't really afford the child to begin with, so what the hell they are doing having a third child, when they can't even afford to take care of themselves, is beyond me.

Why would you assume that? There's nothing in the article to suggest they couldn't afford a third child. They paid out of pocket for the birth and attempted to enroll the baby in a private plan. Their other two kids have coverage. The article also doesn't say that they're on any kind of assistance, and apparently they're both self-employed. This isn't a case of an unemployed person on welfare having yet another baby--that wouldn't be newsworthy, would it?

[alex and astrid 38]

You see, in the view of some, the baby - or his parents - ought to take personal responsibility for the condition the infant is in and earn his privilege to receive the necessary care to live. It's not like the baby has a right to live once he left the womb.

I don't see how the parents didn't take personal responsibility. By the sounds of it, no one knew the baby had a heart condition until it was born. They tried to get it health insurance as soon as possible. I would have done the same thing. What were they meant to do, just let the baby die? It has just as much right to live as anyone else. It's just cruelty, that a human that has a excellent chance at life post surgery is just denied. Are insurers so desperate for money?

[w¡n9Nµ7 §£@¥€r 123]

Are insurers so desperate for money?

Money is why insurers exist.

[alienlovechild 75]

I don't see how the parents didn't take personal responsibility. By the sounds of it, no one knew the baby had a heart condition until it was born. They tried to get it health insurance as soon as possible.

Didn't see anything in the story about prenatal care and I wonder if that birth defect could be detected?

[Staashi 371]

Let the waterworks begin...waterworks have been happening everyday for YEARS!!! It is because of the waterworks situations that the US has allowed itself to get into that people need health care coverage. FYI this situation happens all the time and it is absolutely fvcked up.

[Staashi 371]

Didn't see anything in the story about prenatal care and I wonder if that birth defect could be detected?

It said that they paid for her neonatal care. The situation with her son's heart might have been viewable during a fetal biophysical profile at a neonatalogist's office, but only if he was probably in his last few months. Most women normally don't have biophysicals done on their fetuses, just the 5 month one to check to make sure all organs are accounted for. The profiles are reserved for women who are in high risk pregnancies.

[Mr. Big Dog 10,747]

I don't see how the parents didn't take personal responsibility. By the sounds of it, no one knew the baby had a heart condition until it was born. They tried to get it health insurance as soon as possible. I would have done the same thing. What were they meant to do, just let the baby die? It has just as much right to live as anyone else. It's just cruelty, that a human that has a excellent chance at life post surgery is just denied. Are insurers so desperate for money?

I see your sacrasm meter ain't working. I ain't part of 'some'.

Edited March 27, 2010 by Mr. Big Dog

[alex and astrid 38]

I see your sacrasm meter ain't working. I ain't part of 'some'.

You are right. Tone is mighty hard to read sometimes, when you can't see see the person typing away on the other end. Sorry, I think I am far too used to some of the attitudes on here.

[luckytxn 2,263]

Of course pre existing conditions can cost a lot of money. Costs have to be passed on so prices will be spread across to everyone. Of course since insurance companies need to at the least break even to survive then what happens if they start not making any profit? They will go under and then all will lose their coverage. This means that the Socialists will now win and be able to say that the Feds are the ones coming to the rescue and have to handle their health care. It is all steps for total take over.

[Pooky 3,347]

It's obvious from the article the parents couldn't really afford the child to begin with, so what the hell they are doing having a third child, when they can't even afford to take care of themselves, is beyond me.

That's a little cold-hearted.

Money is why insurers exist.

And yet this administration has mandated that everyone take out health insurance with these leeches. Is that messed up, or what?

Of course pre existing conditions can cost a lot of money.

Doesn't a pre-existing condition require the person in question to be born at the time?

[luckytxn 2,263]

That's a little cold-hearted.

And yet this administration has mandated that everyone take out health insurance with these leeches. Is that messed up, or what?

Doesn't a pre-existing condition require the person in question to be born at the time?

Yes it does and I think that the bay should have automatically been added on birth and neo natal care if the parents had insurance. The costs should have been then spread out to all members on the plan. If we want to join health care plans then we all must share the others costs. We also can't complain if some are hogging more of the outgoing costs. Companies have to make at least a break even point. Some profits are needed to service infrastructure and rainy day funds. If you want a strong company and need investors then you have to be able to promise some kind of return on investment or no one will invest and that can spell no companies that can offer these services.