Sarah WildmanBack to OpinionSarah Wildman

Memo to Okla.: Don’t throw babies out with the bathwater

Imagine this scenario: A child is born eight weeks early. His parents have no health insurance. The baby, they believed, would be covered immediately by insurance they hoped to purchase at the time of his birth. They need it, too; his early birth means a hospital stay, drugs to help his lungs grow, a spell in the NICU.

In Oklahoma, that would mean bankruptcy.

Oklahoma state Sen. Sean Burrage, D- Claremore, left, answers a question during a news conference in Oklahoma City, Thursday, Jan. 12, 2012. Burrage and Adelson said they plan to file legislation that would require health insurers in the state to provide coverage for infants who are not covered under family plans or Medicaid. Photo: AP Photo/Sue Ogrocki

As of December 28, 2011, the state of Oklahoma has now mandated – mandated!– that babies from birth to one year old can now be excluded from health care coverage for families that purchase child-only health insurance plans. Yes, you read that right. This is an opt-out for insurance companies who offer child-only policies, a legal way for insurance companies to skip out on that crucial first year of a child’s life.

In all the strange machinations this country has seen around health insurance, the one thing that seemed most intuitively obvious is that the youngest among us should not be penalized; babies and children in this nation that “values life” should be protected in the cocoon of our care.  Studies have shown that though we spend much more money and time on end-of-life care, we’d be better off, as a society, focusing on the under twos. And health insurance reform seemed to, at least partly, acknowledge that. As of September 2010 under the Affordable Health Care Act, no insurance carrier that covers children is allowed to exclude a child under the age of 19 for a pre-existing condition.

Sounds great, right? The problem is the secondary language: “plans that cover children can no longer exclude, limit, or deny coverage to your child under age 19 solely based on a health problem or disability that your child developed before you applied for coverage.” (Emphasis here is mine.) Though the intentions of those who drafted that text were noble, insurance companies interpreted the language against the grain of goodwill by deciding, all at once, simply not to be plans that cover children. That means parents who do not purchase insurance for themselves, but would purchase it for their kids cannot do so. Also affected are grandparents who qualify for Medicare, but want to purchase plans for grandchildren in their care.

Indeed in states across the country – including Alaska, Arizona, Connecticut, Delaware, Georgia, Minnesota, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Rhode Island, South Carolina, Tennessee, Utah, West Virginia and Wyoming — insurance companies simply stopped offering child-only insurance packages once they were told that the pre-existing condition clause would no longer apply to kids. And those were just the states where all the insurers backed out: In 39 states, at least one insurance company dropped kids-only coverage.

Insurance companies explained it was prohibitively expensive to cover children; most claimed only children with problems would be on the rolls.  That’s not necessarily true though – while there will be some children with birth defects and other expensive needs, the majority of kids, especially in that early year of constant check-ups and vaccinations and growth progress assessment, are healthy, it is just that those check ups and vaccinations aren’t free.

The pool of those affected number (approximately) in the thousands — not overwhelming, but by no means insignificant. State by state, governments worked to reengage (and penalize) insurance companies who had backed out of kid-care, and woo them back towards child-only coverage plans. California told companies that dropped kids they would be dropped from working in the state for five years. Last April, Colorado passed a law making it mandatory for insurance companies to offer a child-only insurance option, Kentucky also reined in  insurance companies, requiring those who had stopped offering child-only plans to reopen sales to child-only needing families. Washington state and New Hampshire also pulled their insurers into line.

But Oklahoma did not go in that direction. Governor Mary Fallin signed an emergency rule at the end of December 2011 that eliminates “birth”  as a qualifying experience for insurance. (Explained well here and here.) State Insurance Commissioner John Doak’s office told press that dropping babies from birth to age one was the only way insurance companies offering child-only policies would agree to come back into the Oklahoma market.

The governor’s press flack blamed the president. “We think it will get more kids covered, said Alex Wentz, “it’s not perfect, but honestly we view it as cleaning up a mess made by the Obama administration.”

Wentz did not address the mess of what happens to paying for the care and vaccines kids need in year one. But more significantly – he did not address the problems that will confront families when children are born with problems that requiring immediate attention, from congenital heart defects to spina bifida.

Sarah Wildman is a columnist for the International Herald Tribune, a regular contributor to The New York Times, Slate and The Guardian, and a contributing editor at The Forward. Follow her on Twitter: @sarahawildman

 

Comments

  • http://www.facebook.com/profile.php?id=1790724191 Victoria Lamb

    Important article. I intend to write to Governor Fallin, giving her a piece of my mind on her cowardice in blaming the PPACA for her own administration’s ignorance and poor negotiating skills. Why on earth didn’t they hire a team of consultants with the knowledge and skills to do the job properly?  By the way, it’s “reined in,” not “reigned in” here:  … Kentucky also reigned in  insurance companies, requiring those who had stopped offering child-only plans to reopen sales to child-only needing families.

  • Anonymous

    Another reason why we need a French-style healthcare system.  All this evil would stop. It would be more effective, cover everyone and cost MUCH less than this corporate-suck-the-life-out of the healthcare system, that we now have.

  • Anonymous

    Thanks Victoria. This has been corrected. — NTK Webmaster

  • Amyv96

    I am unable to fathom that these are actually PEOPLE that make these decisions. I mean, someone should look at these un-empathatic decision makers and ask the question “are we employing executives that have some underlying social disorder?” because this sure makes NO sense to this regular Human Being.

  • Zurichko

    I agree that there needs to be more focus on our youngest population.  How sad that this law is in effect, these babies did nothing wrong.  I’m sure the parents would have loved to be able to provide insurance on their own but it seems like the general public are all in the same boat and motions like this will keep them sinking. 

  • Moocherin’ and Looterin’

    Ahh, the Culture of Life! You know, if people thought about it, they might prefer the more practical morality of the Europeans, where there is sex education, pre and post natal care for young mothers, and interestingly enough, fewer abortions per capita than in our own very special and ostentatiously “Christian” nation. Good thing our own very impractical morality encourages people not to think very hard- at all!

  • Moocherin’ and Looterin’

    Ahh, the Culture of Life! You know, if people thought about it, they might prefer the more practical morality of the Europeans, where there is sex education, pre and post natal care for young mothers, and interestingly enough, fewer abortions per capita than in our own very special and ostentatiously “Christian” nation. Good thing our own very impractical morality encourages people not to think very hard- at all!

  • A Richardson

    Shameful!

  • A Richardson

    Shameful!

  • http://profile.yahoo.com/IGKMYFYNPGSXENPZ4M2XWYCQDM Scott

    “Once you leave the womb, conservatives don’t care about you until you reach military age. Then you’re just what they’re looking for. Conservatives want live babies so they can raise them to be dead soldiers.”
    George Carlin

  • http://profile.yahoo.com/ZPLQIB2OPBVPC2NVJQKRHERBPY eznow

    Wow! no DAYUM!

  • Siouxgilber

    This is FUBAR. 

  • http://profile.yahoo.com/VLJLV6HCOWXOQ2MFWTHKJVGK4A John

    If you want fair treatment vote DEM. Con. only care about babys in the womb as soon as their born they don’t care any more. We should have health care for everyone. Most every other developed nation has it but us. What we have is a middle man health insurance industry thats going to get richer. We need at least a public option.

  • Anonymous

    Those who are executives of insurance companies not only have no heart they have as little empathy for the common person as is entirely possible. The very notion of insurance for children under the age of 1 is ludicrous to them, they plan on not covering any child soon. 
    It is now imperative that America adopt the practical ethics of Europe and other developed countries and stop with this nonsense of a ” Christian nation” altogether. We are not and never have been by the very nature of Christianity a Christian nation, for Cain asks of God, “Am I my brother’s keeper?” God answers in the affirmative. Remember the parable of the Bad Samaritan? Oh didn’t you read that one, where even the Samaritan left the injured traveller by the wayside to die? Because this is what it seems like to me, that the far right wing squirrel nut job fundamentalist Christians have shown to their fellow man.
    We cannot long abide the ongoing war of Christianity against people who are poor and disabled, or more accurately not like them. There must be a cultural change if we are to survive as a nation. We cannot allow the forces of one religion to rule the other portions of our people. We must change the way business is done, we must rein in the runaway capitalist regime and stand firmly against forces that would starve our future of education, health care and decent jobs. 
    If we don’t do these things, if we lie down and let the steamroller of religion roll over us, then we will have accomplished what they want a country divided against itself. 

  • Thibbs35

    The whole problem lies in the phrase “if people thought about it.” This is a nation of non-thinkers. People are quite content to believe what their pastor and Fox News tells them to believe. Thinking is hard work and it will inevitably lead you to recognize issues with your belief system. That is way scary for most people, so they don’t think. And we end up with the nonsense we currently have masquerading as politics in this country.

  • Mmzcsmith

    Thank you for bringing this to light.  I am disappointed again in the lack of corporate responsibility.  Corporations want to be recognized as people with rights to participate in this country yet deny basic human needs and yes rights to live in health.  I will not mention those who preach how important life is as I don’t think they would applaud this effort either.  

    This is just another instance where Greedy CEO’s have decided to manipulate a good law to allow them to do the wrong thing and blame it on someone else.  ”See, the law made me cut programs to new borns and children under the age of one.”  ”There was nothing we could do.” “We couldn’t actually make a moral decision not to cut this portion of our population because they are expensive and need more care at this age.”  ”They cut into profits and everyone knows that this is really the moral decision we need to be making for our stockholders.”  

    It is a decision of the insurance company that bets against your health and penalizes you for being unhealthy whether your can help it or not.  It is disgusting.  

    Now those of you who will stoop so low as to call me a communist, or anti-corporation, and even ignorant, and hate my country.  I already have heard your dried up arguments and instead want to hear why you think this is a good business decision.  You don’t want government in business tell your business partners to stop making bad decisions.  

    I would also like to apologize in advance if you are offended at my point of view.  I am meant nothing personal just disappointed in all involved in this issue for not coming up with a solution but instead pointing fingers and calling names.  

    In the end my heart goes out to those parents who need the help and my prayers for our children and future generations.
     

  • Grumpy58

    I cannot connect the dots – there is a measure similar to the failed person-hood bill in Missouri being discussed one that would created a Law protecting an unborn Fetus, while at the same time the Insurance lobby effectively controls how that same ‘Life Form’ will not have health care when it takes it’s first breath. Conception – Battlefield – Grave. That seems to be the cycle of life being recognized by the Majority in State Governance. Kudos to the Democratic minority and specifically Burrage and Adelsonfor bring attention to this repugnant issue.

  • Jdb1491

    I’ve said it before, and I’ll say it again . . . Oklahoma is a great state to be FROM !!!  I cannot explain the kindergarten level of ramblings, musings, and pontificating of all the so-called “politicians” – not to mention those of the voting public – that originate in and then emanate from the state-of-mind  people politely refer to as, ahem, Oklahoma.  Buh-bye, Norman . . . .

  • Eldredfuchs

    Fubar’s my cat, he smarter’n nat

  • Janeese

    Most parents would be happy to maintain coverage for the entire family, if affordable.  As the cost of medical care continues to skyrocket, most times, we are faced with tough choices… Greed of insurance companies now threatens not only the health & welfare of America’s children, but their very existence! I agree: “Don’t throw babies out with the bathwater”!

  • Glide23

    Oh yea keep pumping them out whether you can afford them or not

  • http://www.facebook.com/mikeobeirn Michael Obeirn

    How miserably predictable. Did anyone honestly expect the Oklahoma Legislature to demand that the Health Insurance Companies cover the medical needs of  babies from birth to 1 year of age. Most of whom will be from lower income, or similarly disadvantaged families. (Please, add your own non PC buzz words in here) 
    Truly this is the penultimate expression of the kinder gentler Christian nation that most if not all of our Republican Candidates and their right wing Fundamentalist, Evangelical, Roman Catholic and Mormon contributors and ideologists envision.
    Their compassion lingers only like a rank odor over the gestating womb of any woman from conception to birth. They will do everything and anything in their power to save the life of the unborn. That includes murder, (Tiller), bombing (Rudolph) intimidation but woe betides that child at birth. They don’t give a damn till it’s 18 and can vote or go to war. I won’t even go into their ongoing campaigns to return women to chattel property and Duggerganger baby factories. 
    Go ahead, let them do it. Excuse my brutal language, let the freak show begin, dwarfism, spina-bifida, cleft palates, small pox scars, club feet, so many more medical issues that could be addressed early in life for so little money. Babies and Bathwater phaaa, talk their language Pennies and Pounds. 
    These people who put forward these regressive laws are cowards. The haven’t the courage to envision an America that embraces inclusion and fairness. They are cower behind hack kneed philosophies that excuse their malfeasance and justify their gutlessness.

  • Mickfan22

    What is going on in this country.??? Feels like we are systematically eliminating the poor who are defenseless Yesterdays action by the Koman Foundation is a perfect example.. Does anyone realize what would happen if these people were able to take over the federal government, seniors, disabled etc would be next. Why does this movement feel familiar.

  • http://www.facebook.com/people/Shelli-Dawn/665935030 Shelli Dawn

    what a pathetic remark!!!!

  • mary t.

    photoshock, You have stated quite clearly my own thoughts on these matters. The way things are going in this country terrifies me. ‘Christians,’ BAH, I say! They are dragging this country and its people into a morass of vileness, hate, discrimination, removal of any and all human rights, yet have the utter gall to scream discrimination when they are called to task for their machinations and politicking.

    I was raised Roman Catholic and never in my life have I seen a more hateful, repressed and vitriolic group of people.They say they have only love for their fellow ‘man’ and only want all of us to live lives that are full and loving and peaceful. What a crock. Santorum and Gingrich are the spokespeople for this madness that is christian/Catholic fundamentalism; will we allow this vermin and his ilk to run this country? Will we allow them to tell us who can be healthy and for how long? Will we stand by and continue to watch as our lives and liberties are dismantled and sold to the highest bidder? Why are so many people angry about this and NOT doing anything? We write comments about how we will fight, but how do we do it?? How do we fight such idiocy on such a large scale? I am terribly afraid that this is the Third Reich all over again but in different packaging. How do we fight this?

    I actually want to cry…at the loss of my freedoms, my health and the health of those I love (this I know from personal experience: insurance company telling my boyfriend that his disintegrating spinal column is not a big deal and they won’t cover surgery and he is forced to work as his company’s disability insurance carrier stated ‘pain is not a covered disability’ never mind he cannot function without massive pain patches and oral meds and his spine is disintegrating mri by mri …but I digress), that CEO’s make more in a month than my household makes in a year, and my children cannot go to college as our savings has been stripped away…and on and on it goes for all of us.

    So how do we fight this? Yes, we vote, but even that is not a sure thing any longer as the republicans taught us not so long ago. I want to help save this country and her people, but I have no idea how.

  • mary t.

    photoshock, You have stated quite clearly my own thoughts on these matters. The way things are going in this country terrifies me. ‘Christians,’ BAH, I say! They are dragging this country and its people into a morass of vileness, hate, discrimination, removal of any and all human rights, yet have the utter gall to scream discrimination when they are called to task for their machinations and politicking.

    I was raised Roman Catholic and never in my life have I seen a more hateful, repressed and vitriolic group of people.They say they have only love for their fellow ‘man’ and only want all of us to live lives that are full and loving and peaceful. What a crock. Santorum and Gingrich are the spokespeople for this madness that is christian/Catholic fundamentalism; will we allow this vermin and his ilk to run this country? Will we allow them to tell us who can be healthy and for how long? Will we stand by and continue to watch as our lives and liberties are dismantled and sold to the highest bidder? Why are so many people angry about this and NOT doing anything? We write comments about how we will fight, but how do we do it?? How do we fight such idiocy on such a large scale? I am terribly afraid that this is the Third Reich all over again but in different packaging. How do we fight this?

    I actually want to cry…at the loss of my freedoms, my health and the health of those I love (this I know from personal experience: insurance company telling my boyfriend that his disintegrating spinal column is not a big deal and they won’t cover surgery and he is forced to work as his company’s disability insurance carrier stated ‘pain is not a covered disability’ never mind he cannot function without massive pain patches and oral meds and his spine is disintegrating mri by mri …but I digress), that CEO’s make more in a month than my household makes in a year, and my children cannot go to college as our savings has been stripped away…and on and on it goes for all of us.

    So how do we fight this? Yes, we vote, but even that is not a sure thing any longer as the republicans taught us not so long ago. I want to help save this country and her people, but I have no idea how.

  • http://profile.yahoo.com/VEHDLBZU5A256LCVFXUISFFI7I R.C.K Jr.

    Ah but greed is good!   Its not only the insurance CEOs and ALL share holders in such  companies but also the Doctors themselves and the political body that allows the greed to continue. Add to this if you are healthy there is no need for insurance.  There is no need to see a doctor every year or 6 months  (as recomended by anyone in the business)  I have not had insurance for almost 20 years now, I go to the Doctor when I need to . . . when I am sick or hurt.  But I have to say that the one time I needed help being struck with a debilitating sciatic condition I could not get any help, none.  All I got was pills.  Another big part of the business  BIG PHARMA.  This whole idea that you NEED to see a doctor every so often is the same as needing to go to the car mechnic to get air in your tires every three months.  And when you do there is almost always something else wrong with your car.  Its just  tough finding an honest mechanic as it is an honest Doctor.  They are in it for ONE REASON  $$$money$$$.  Forget ethical treatment when you are going to die.  All they are interested in is sticking an IV to you wallet and sucking all they can from it. And now reading that looking to give care to babies who could need it (and I say COULD need it) being denighed because of cost I have to say well what would you expect?  It’s business and in business you have to grow AND make money!!! Plus no one is mentioning the insurance that Doctors have to pay in order to practice.  The other reason it cost so much are the premium they have to pay.  So think about it, your insurance is supporting the insurance . . . . hmmmm and isn’t it the insurance companies who lobby our leaders to pass the “laws” creating policy?  In my view it is a circle jerk each greedy bastard stroking the next for the money that will allow them the better life America can provide for the top 2%.  Forget the rest of us.  You need to first cut the head off to save the body . . . . but no one will because no one can. 

  • http://profile.yahoo.com/Q7O5E6DJMFOCAHAQCR32HUNW3I R

    well when a political party rules out contraception and abortion I guess they will be “pumping” them out.

  • http://profile.yahoo.com/Q7O5E6DJMFOCAHAQCR32HUNW3I R

    This is what happens when Wall Street is allowed to be involved in healthcare it become CAN’T