Michelle

MSNBC.com

Toddler denied insurance for being too small
Aislin Bates, 2, weighs just 22 pounds but her doctor says she is healthy


TODAY
updated 9:53 a.m. ET, Wed., Oct . 21, 2009



First, a Colorado baby was turned down for health insurance for being too big. Now, another Colorado child has been turned down for health insurance for being too small.
Just a week after TODAY highlighted the story of 4-month-old Alex Lange, who at 17 pounds was considered obese, the show presented Wednesday the equally curious case of 2-year-old Aislin Bates, who at 22 pounds was turned down for health insurance for not meeting a proposed insurer’s height and weight standards.
Aislin’s dad, Robert Bates, told TODAY’s Erin Burnett he was shocked that United HealthCare turned down their request for coverage when their daughter is basically a picture of health, having suffered nothing more than a common cold in her life. Doctors have told Robert and his wife, Rachel, that Aislin’s small size is purely a matter of genes, not ill health.
“It seems as if they’re discriminating about the fact that she’s smaller, that her size is an issue,” Robert Bates said. “I don’t see why that would be a factor in whether or not a child is healthy.”
Bates told TODAY that he and his family were previously insured by United HealthCare. Two months after Aislin was born, his employer switched plans to Guardian Health Insurance. In August, Bates left his job to become self-employed, and he went back to United HealthCare requesting coverage. The insurer turned down coverage for Aislin — even though it had already insured Aislin as an infant — stating she did not meet height and weight standards and also noting the Bateses had sought treatment for Aislin’s finicky eating habits.
Doctor says child is normal
As the Bateses appealed the decision, their own family doctor went to bat for them, writing to the insurer and stating Aislin’s small size was genetic, that she was developing normally and there was no reason to deny coverage. But Robert Bates said the company rejected the appeal, simply reiterating that Aislin didn’t meet underwriting standards.
Rachel Bates told Burnett their daughter “is not sick at all; she’s just petite, and that’s the issue.” She said little Aislin has been graded in the 3rd percentile for child height and weight, but has been progressing normally in her own range.
Robert and Rachel realized Aislin was a picky eater early on, and went the extra mile to enroll her in food therapy. But instead of earning brownie points with the insurer, the family believes having their daughter in treatment is actually being held against them.
Therapy for picky eating
“We wanted to fix her picky eating, because we want her to be able to eat a wide variety of foods, and not just things she wants to eat, like chocolate,” Rachel Bates told TODAY.
“We personally sought out therapy; it was not prescribed by a doctor. In the process, it was found that [Aislin] has just a minor, minor gag reflex, causing her to not like certain foods. But the therapist says she’s thriving and fine, and she’s developing normally and in fact, possibly advanced.”
Appearing on TODAY with the Bates family, which also includes 3-month-old boy Elliott, Dr. Nancy Snyderman quickly broke in when Burnett professed she didn’t understand what the problem is with insuring Aislin.
“You don’t understand? Because there’s nothing here to understand,” Snyderman said. “This is just so bogus. A pre-existing condition for a child this age is birth, let’s be real!”
The case of Alex Lange had a happy ending. After the family appeared on TODAY, Rocky Mountain Health Plans reversed its decision and agreed to insure the child, and admitted there was a flaw in its underwriting system.‘Cherry-picking of health plans’
Robert Bates, to date, has had no such luck. While he continues to lobby United HealthCare to cover Aislin, the family has been forced to look at other options. Aislin is currently insured under a COBRA plan from Bates’ previous job, but it expires in 18 months.
Snyderman was clearly agitated that the Bates family has to go through worry and uncertainty over insuring Aislin, and said her prognosticating skills have unfortunately been proven accurate.
“Last week we talked about how crazy it was that there was a chubby baby being denied, and I said next thing you know, we’ll hear about the skinny kid. So here’s the skinny kid,” she said, pointing to Aislin.
“I think what we’re really seeing is the cherry-picking of health care plans across the country,” Snyderman said, adding, “If anyone doubted the significance of health care reform in this country, this is why things have to change.
“This is egregious.”

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Michelle

Insurer changes its mind, covers ‘too small’ tot
2-year-old was turned down due to her size, even though she was healthy

By Michael Inbar
TODAYShow.com contributor
updated 10:06 a.m. ET, Thurs., Oct . 22, 2009

Robert and Rachel Bates of Colorado knew their 2-year-old daughter was healthy, even if she was small. And now they can rest assured that they will have medical insurance to help keep her that way. Aislin Bates, who at 22 pounds was deemed too small to qualify for medical insurance, has now been accepted after all.

Hours after Aislin appeared on TODAY Wednesday along with her parents, their proposed insurer, United HealthCare, issued a statement saying, “As part of our standard appeals process, we undertook additional review of Aislin Bates’ medical records and determined, in fact, we can offer her health insurance coverage.”

Contacted by TODAY Thursday, Rachel Bates said she was “extremely excited” at the news. “We were just so elated by the news and we are so thankful,” she said. “They made the wrong decision at first, but now they have made the right decision.”

Picking cherries
Only a week before, TODAY highlighted the case of Alex Lange, a 19-pound 4-month-old who was turned down for health insurance for being too big. After Alex and his family appeared on TODAY, Rocky Mountain Health Plans flipped back and agreed to insure the child, while admitting there was a flaw in its underwriting system.

While TODAY’s medical expert, Dr. Nancy Snyderman, remarked that “NBC may end up changing the health care system one anecdote at a time,” she added that the cases of the Bates and Lange families highlight the urgency of reformed health care.

“If anyone doubted the significance of health care reform in this country, this is why things have to change,” Snyderman said, adding, “What we’re really seeing is the cherry-picking of health care plans across the country.”

The about-face on health insurance surely was especially surprising for the Bates family, since dad Robert Bates told TODAY Wednesday he had previously been told by United HealthCare his appeal for insurance had been turned down.

Size discrimination
Bates said he was shocked about the turndown because Aislin is quite healthy, having suffered nothing more than a common cold in her life. Doctors have told Robert and wife Rachel that Aislin’s small size is purely a matter of genes, not ill health. “It seems as if they’re discriminating about the fact that she’s smaller, that her size is an issue,” Robert Bates said. “I don’t see why that would be a factor in whether or not a child is healthy.”

Two months after Aislin was born, Bates’ employer switched plans from United HealthCare to Guardian Health Insurance. In August, Bates left his job to become self-employed, and he went back to United HealthCare requesting coverage. The insurer turned down coverage for Aislin — even though it had already insured Aislin as an infant — stating she did not meet height and weight standards. The company also noted that the Bateses had sought treatment for Aislin’s finicky eating habits.

As the Bateses appealed the decision, their own family doctor went to bat for them, writing to the insurer to assert that Aislin’s small size was genetic, that she was developing normally, and that there was no reason to deny coverage. But Robert Bates said the company rejected the appeal, simply reiterating that Aislin didn’t meet underwriting standards.

‘Push back’
Rachel Bates told TODAY’s Erin Burnett Wednesday that their daughter “is not sick at all; she’s just petite and that’s the issue.” She said little Aislin has been graded in the third percentile for child height and weight, but has been progressing normally in her own range. But the fact that the Bateses had enrolled Aislin into a food therapy program was evidently held against them.

Talking with TODAY Thursday, Rachel Bates said she and her husband haven’t yet had time to decide whether they will stay with United HealthCare. “At least they were big enough to go back and admit, ‘We didn’t make the right decision,’ ” she acknowledged. “But I’m definitely not pleased we had to go through this process.”

Bates added that she hopes her family’s story will be an inspiration to others going through similar problems with insurers.

“I encourage anyone who’s going through this to push back — to be respectful of the process, as we tried to be respectful to all parties, but to not give in to the ridiculousness,” Rachel Bates said.


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