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Newborns can have pre-existing conditions? March 31, 2010

Posted by Ken in Health Care.

In a recent ABC News piece (here), the story of one family’s ordeal in trying to get health insurance coverage for their newborn after it was diagnosed with a severe heart condition (dextro-transposition of the great arteries). After applying and being refused by Blue Cross Blue Shield of Texas (BCBSTX), they applied to the state-run insurance pool (Texas Health Insurance Risk Pool) and will get coverage for thier child for about $10/month more than the original BCBSTX plan they tried to enroll their child in.

The press paints this as evidence of problems in the helath insurance industry, but they ignore the fact that none of the bills recently signed into law had any impact on this family’s ordeal – the pre-existing state-run insurance plan covered the child. This insurance pool pre-existed the year-long health-care debate and subsequent changes in federal laws, and is proof that in cases like this there were options available before Health Care Reform.

A few things to note:

  • If the parents were insured, that coverage would extend to the child for the first 31 days, with the parents having the choice of opting in to coverage for the child or not – the insurance company couldn’t refuse coverage of the child at this point.
  • This family could get health insurance coverage before the child was born, but THEY CHOOSE NOT TO ENROLL, it was too expensive – once the HCR bill kicks in, they won’t have that choice – they’ll have to buy insurance instead of rolling their income back into their small business.
  • The pre-existing, state-run health insurance system will/is covering the child at a competitive price ($10 more than the private plan the family was denied) – seems like the system is working, not fatally flawed and in need of “fundamental transformation”.
  • The family in this piece has two other children that are covered by BCBS, and through the state-run insurance pool this child will be covered – where is the problem? Aside from a few stressful days, this child will have coverage (if he does not already).


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