Parenting

Monday, November 30, 2009

Mom denied health insurance for having a C-section

Try this one out: You're a stay-at-home mom who has had two sons via Caesarean Section. Your husband is self employed, and you are in the market for health insurance. You find a large, well known provider who will cover your family with just one hitch: you must get sterilized first.

No, this is not some brave new Gattaca-esque world, where we've decided to hone a race of super humans by selectively weeding out the weaker of the species. This is America, where C-sections occur in  more than 30% of all births, and where Colorado mom Peggy Robertson, who is in good health, was told to stop reproducing so Golden Rule Insurance, a subsidiary of United Health Group, could  profit from her policy.

Yes, really. Golden Rule was even kind enough to provide unapologetic reasoning in a detailed letter:

"As a general rule, our underwriting guidelines require that we issue coverage with a rider excluding benefits for caesarean section delivery for three years. However, the Colorado Division of Insurance no longer allows us to place that rider... Unfortunately, we cannot collect sufficient premium to offset the risk of paying for a repeat C-section delivery during the first three years of coverage...In order to consider coverage without a rider, we require...some sort of sterilization. "

Translation: Your state  forbids us from denying you coverage for a C-section, so we've decided to deny you coverage, period! Oh, unless you get sterilized.



Really, Golden Rule Insurance? You're really going to stand by a policy that could potentially deny 1 in 3 women coverage, based on the fact that they've had an extremely common medical procedure, and might have it again?

Last Thursday, when Robertson shared her story with the Senate's HELP Committee hearing, Senator Mikulski called Golden Rule's actions "bone-chilling" and "morally repugnant." In the same hearing, Robertson detailed how another company denied one of her son's  health insurance for holding his breath during tantrums and for being "too small." Yes, really. Apparently, children shouldn't be small anymore if they're going to qualify for health insurance!

If we've created a system in which healthy women, too small children, and regular, hard working Americans are denied insurance, then who exactly qualifies for coverage? The people that don't need it? That's some system.
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From the Community…

Comments 1-10 of 24
  • AshleeT's Avatar
    Posted by AshleeT Tue Oct 20, 2009 11:34am PDT

    That is ridiculous! Insurance in this country is nothing more than a joke.

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  • Jed's Avatar
    Posted by Jed Tue Oct 20, 2009 11:54am PDT

    Absurd! The "free market" in health care is at work!

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  • C's Avatar
    Posted by C Tue Oct 20, 2009 12:44pm PDT

    Then there was the four month old breastfed baby who had a preexisting condition of obesity because he was above the 95th percentile for his age...

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  • ?'s Avatar
    Posted by ? Tue Oct 20, 2009 1:56pm PDT

    Boo-hoo, Find another insurance carrier.

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  • Brittany's Avatar
    Posted by Brittany Tue Oct 20, 2009 2:32pm PDT

    Ya gotta love the free market.

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  • Crystal's Avatar
    Posted by Crystal Tue Oct 20, 2009 5:34pm PDT

    Since when did Americans become diluted into thinking that health insurance was for the policy holder's benefit?! It is a billion dollar industry for a reason. By giving insurance to those who rarely need it and only need it for small instances, the company makes a TON of $$$. This system that has been created can't and won't last. Its gotta give at some point. And by that point, healthcare will be so expensive none of us will be able to afford it.

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  • Robyn's Avatar
    Posted by Robyn Tue Oct 20, 2009 7:34pm PDT

    if they wanna be that way then they should pay for the birth control twist, where you cant get preggers for 5 years

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  • mel's Avatar
    Posted by mel Tue Oct 20, 2009 10:09pm PDT

    and foriegners want to come here to be "free"? what a crock! this isn't a free country anymore. we are now under the rule of a dictator worse that castro! the insurance dictators!! when do we revolt?

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  • FallingSpider's Avatar
    Posted by FallingSpider Wed Oct 21, 2009 8:43am PDT

    In any other setting wouldn't a demand like this be sexist, and potentially carry legal implications. I mean if an employer said "we can't hire you because you might get pregnant again, so we need you to get sterlizied first." There would be lawsuits flying before they finished speaking. Why are insurance companies above the law?

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  • Brandy D's Avatar
    Posted by Brandy D Wed Oct 21, 2009 9:23am PDT

    It is a free country...well somewhat fee. If one insurance company wants to do this, so what...find somoene else. The thing that is great about living in a free market is that you get to pick and choose and so do they. She probably wouldn't be able to afford the pregnancies on her own without health insurance, so she should be greatful that they are even there.

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Comments 1-10 of 24

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