In The Way Of Insurance Company Profits: Kids

Part two in a five-part series on Insurance Companies and the quest for giant profits at the expense of people who need health insurance. -----

Posted Tuesday, October 27, 2009 by Christy Harvey, Mic Check Radio

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Rocky Mountain Health Plans refused to cover a 4-month-old baby who weighed 17 lbs. because it said the baby was too fat. (They said the infant had a “pre-existing condition for obesity.") After the story made national news, the company backtracked and agreed to cover the kid (who was perfectly healthy, by the way.) [Denver Post]

United HealthCare refused to cover a 2-year old tot who weighed 22 lbs. because the child was too skinny. They also cited evidence that the parents sought advice for the child’s finicky eating habits as a reason to deny coverage. (Somebody didn’t like her vegetables.) The little girl’s doctor disagreed, saying the child was perfectly healthy and merely petite. [MSNBC]

Two kids in Kentucky, Jesse and Jayme Williams, were genetic carriers of a condition called alpha-1 antitrypsin. (People who end up contracting the disease lack a liver protein which helps block the effects of certain enzymes related to emphysema and liver disease.) Keep in mind, the kids didn’t *have* the disease, they just had the genetic makeup that *carried* the disease; doctors say they are no more likely to contract the protein deficiency than you or me. That didn’t matter to the Humana insurance company, however, which refused to cover the kids. After a big legal battle, Humana reversed their decision. [AP]

The Consumer Watchdog group in California is suing the state’s Department of Managed Health Care for allowing private insurance companies to routinely deny coverage of treatments for kids with autism. After insurers refused to cover autism needs, the state legislature passed the Mental Health Parity Act in 1999. The insurance companies get around this, however, by claiming one of the most effective (but expensive) treatments, Applied Behavioral Analysis, is experimental and educational but not medical and, thus, they won’t cover it. [ABC News]

Insurance companies in Wisconsin refuse to pay for hearing aids for children born deaf. Said one mom, struggling to afford $5,000 hearing aids for her deaf 15-month-old, “You break a leg, you get a cast paid for. He has broken ears and I can’t get that fixed.” [TM4]