TODAY   |  October 12, 2009

Baby denied insurance for being ‘too fat’

Oct. 13: A Colorado couple was initially denied health insurance for their 4-month-old son because he was overweight. NBC’s Michael Okwu reports and NBC’s chief medical editor, Dr. Nancy Snyderman, weighs in.

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>>> back at 8:09, and now to a story that will shock and outrage a lot of parents. a colorado couple initially denied health insurance for their 4-month-old son because he was too fat. nbc 's michael okwu has the story.

>> reporter: little alex lang isn't so little.

>> he is about 18, 19 pounds at 4 months old.

>> reporter: and that wouldn't be much of an issue, except his parents believe at 4 months old, dimpled, chubby alex , who they lovingly call chunky monkey , is already a symbol of what's wrong with the health care system .

>> i was stunned, you know, kind of speechless.

>> reporter: although alex is happy and healthy, kelly and bernie lang applied for individual health coverage for their son when he was 2 months old, but they were turned down. the insurer's reasoning? he was simply too fat.

>> we certainly were not going to deny him when he wanted to eat. you don't deny an infant, a baby, food when he's hungry.

>> reporter: alex 's weight put him in the 99th percentile. again, he's perfectly healthy, but the underwriting guidelines say that any child above the 95th percentile is considered obese, a financial risk , and therefore, uninsurable.

>> it's like we're being punished, you know?

>> reporter: experts say those guidelines, which are relatively new, are flawed.

>> i think that the guidelines that they've used were just ridiculous. they just aren't helping anybody and actually probably pushing some people into being uninsured.

>> reporter: alex 's father, a local tv news anchor, put his story on the air. the outrage it caused compelled the insurer, rocky mountain health plans, to change their policy and provide "coverage for healthy infants, regardless of their weight."

>> at the end of the day, it's not about a rigid set of rules or standards. it's about, is this a person that should be covered, and if so, how do we get them covered?

>> reporter: it's good news for baby alex . not just a pretty face, but also now a weighty symbol in the health care reform debate. for "today," michael okwu , nbc news, los angeles .

>> and weighing in now, dr. nancy snyderman , nbc 's chief medical editor. good morning to you, nancy.

>> hi, meredith.

>> so, alex is 4 months old, weighs about 18 pounds, 25 inches long, puts him in the 99% bracket for kids his age. was the insurance company right to be concerned about his future health?

>> oh, i think this is going to just show the errors in our system. this is a breast-fed baby, not being fed junk food , lean parents, rocky mountain health plans, one of the signature health plans people have been touting as a plan that can do it right, and conscientious parents who realize that they wanted more coverage for the family. there's nothing good about this. and the presumption from the aspect of the health insurance company is that if you're a chubby baby, you're going to become an obese teenager, obese adult, tap more health care dollars. the reality is we don't know that. growth curves are just that, somebody has to be zero and somebody has to be 100 and others fall within. he was above normal.

>> so how do we get to the point that the kids don't have insurance?

>> you take away the fact. my nephew has down syndrome, healthy his whole life. he's never been able to get insurance. why would you say that something that starts in utero would deny you coverage in this country? it's the craziness of a pre-existing condition. if you take a baby like alex , who is just chubby, you can say to everybody in utero, everybody, you have something in your genes that's going to predispose you to something down the line, and that is the caveat for insurance companies to say you're too high-risk.

>> what about -- i mean, he's 4 months old and is being breast-fed. what about the parents of a child who's like 10 and obese? should they be forced to pay more?

>> well, i would flip it around and say do you deny a child health care because of the errors of the parents? my concern is i worry about immunizations, i worry about a child getting the flu, about a kid using the er instead of the pediatrician's office. we know people without health care access the stimulater in illness, sicker and cost us more money. and if we flip that around and this kid were too skinny and made up 3% to 5% of the growth curve and weren't eating enough, would we kick that child out? no, we would say, oh, my god, there's a crisis. we absolutely need that child in.

>> we saw that north carolina state employees would have to pay more for insurance if they're overweight.

>> because they're adults.

>> is that a growing trend?

>> increasingly -- watch this, the self-responsibility issue is going to be addressed. i think sugar and fat are going to be taxed, much like cigarettes. and people can talk about regressive issues, but the reality is, cigarettes and obesity consume 30% of our health care dollars. this is a seismic shift in how we have our conversations. that part for adults is not going to go away, but egregious what rocky mountain did in this case.

>> quickly, will health care reform address these pre-existing conditions and whether or not you're allowed to get insurance?

>> yesterday we thought the health insurance industry was going to say no more pre-existing conditions. now politics is hijacking that, but i don't think there's any way the industry can condone pre-existing conditions as a way of negating coverage. that's the capitol hill discussion right now.

>> thank you, dr. nancy.

>>> up next, what you don't know about the hero on the hudson. matt talks with captain sully sullenberger, after this. * do you have a crooked smile? do your eyes... ...sit wide? * do your ears sorta wiggle? * does your hair make you giggle?