Insurer changes its mind, covers ‘too small’ tot

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.

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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. Video: Petite tot denied insurance

“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.”

Video: Baby denied insurance for being ‘too fat’

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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