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Baby Denied Health Coverage Due to Preexisting Condition
By Catherine Donaldson-Evans Mar 29th 2010 11:07AM
A Texas newborn who needed surgery to correct defective arteries was denied coverage by his parents’ insurance company on the grounds that the baby’s condition was preexisting.
Emboldened by the new federal health-care legislation that will make such claims illegal, Houston Tracy’s parents are fighting the decision by Blue Cross and Blue Shield of Texas, according to local reports.
“They kept saying it’s preexisting, it’s preexisting, but I don’t know how it can be preexisting on a baby that was just born,” the child’s father Doug Tracy told CBS affiliate KTVT. “If it’s mandated that everyone have health insurance, then how can one be denied?”
Blue Cross issued a statement to AOL Health Monday saying the company is addressing the Tracys concerns, but offered no details on how it was doing so.
“We understand what an emotional time this is for the Tracy family and we regret the frustration they are feeling,” the statement says. “Under privacy laws, we can’t discuss the specifics of any individual’s health care or coverage status with our company. What we can tell you is that we’ve responded to Mr. Tracy in writing over the weekend and are pleased to report that we’ve proposed a solution that addresses his and his family’s concerns.”
AOL Health was unable to reach the Tracys for comment.
The federal health-care legislation passed by Congress and signed by President Obama last week will stop insurance companies from being able to deny children coverage for preexisting conditions. But it doesn’t go into effect until September, meaning Houston came into the world just a little too early.
After the Tracys’ son was born on March 15, doctors found that he had a congenital heart disorder called transposition of the great arteries, according to media reports. Babies with the condition — which is almost never detected before birth — turn blue because the two major vessels that transport blood away from the heart are reversed.
Houston’s dad knew something was wrong right away.
“He wasn’t turning pink fast enough,” Tracy told the Fort Worth Star-Telegram. “When they listened to his chest, they realized he had an issue.”
But he was stunned when his insurance company wouldn’t pay for Houston’s operation, which the infant needed in order to survive.
“How can he have a preexisting condition if the baby didn’t exist until now?” the paper quoted Tracy as saying.
He and his wife Kim, who are small business owners, say they can’t afford coverage for themselves but pay for health insurance policies for their other two children.