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Under fire, Blue Cross Blue Shield of Texas offers to cover medical expenses for Crowley baby

03/30/2010 11:56 PM

03/31/2010 3:43 PM

Houston has health insurance.

The news, announced on a Web site set up for the Crowley baby, ended his family's weeklong fight after the newborn was denied health insurance because he needed surgery to repair a heart defect -- what the insurance company called a pre-existing condition.

Doug and Kim Tracy's battle with Blue Cross Blue Shield of Texas garnered national attention, coming on the heels of historic healthcare legislation, signed by President Barack Obama a week ago, which will require insurance companies to cover pre-existing conditions.

The Star-Telegram reported on the Tracys' problem on Friday. That evening, Darren Rodgers, president of Blue Cross Blue Shield of Texas, personally contacted the family. Initially he offered to see whether coverage through the Texas Health Insurance Risk Pool could be back-dated to the baby's birth, Tracy said.

But when that was not possible, he offered to work with Cook Children's Medical Center to pay for Houston's medical care.

On Monday, a letter outlining the offer was sent by courier to the Tracy home. Blue Cross Blue Shield agreed to pay the baby's medical expenses from his birth on March 15 through March 26, when coverage through the risk pool took effect. Houston's surgery took place on March 19.

"I feel like Blue Cross Blue Shield finally realized they made a mistake and did come through for me," said Tracy, 39. "I am happy this is taken care of and my little boy is going to be fine."

Privacy laws prevent Blue Cross Blue Shield of Texas from commenting on individual situations, said Margaret Jarvis, a company representative.

"We understand what an emotional time this is for the Tracy family and we regret the frustration they are feeling," a statement from the company reads. "What we can tell you is that we've responded to Mr. Tracy in writing over the weekend and are pleased to report that we've proposed a solution that addresses his and his family's concerns."

Tracy said that coverage his son will get through the Texas Health Insurance Risk Pool will cost only $10 more than the policy that he was denied.

Doug and Kim Tracy do not carry health insurance on themselves, but they do cover their two other children and planned to add Houston. The couple said that they are self-employed and find insurance for themselves too expensive. She owns a beauty salon and he owns Burleson Scuba and Paintball. They paid for prenatal care and hospitalization out of their pockets.

Tracy said he called Blue Cross Blue Shield of Texas before the baby's birth to get the child covered but was told by an insurance representative that he had 30 days after the birth to apply for a policy. Then the baby was born with the defect.

After the denial of coverage, friends rallied around the family and contacted politicians and the media to publicize the situation. State Rep. Chris Turner, D-Arlington, and Sen. Wendy Davis, D-Fort Worth, asked Blue Cross to reconsider its decision. Turner said that it was great news that the medical bills would be covered.

"I commend Doug and Kim for their tenacity in fighting for their son, and am grateful to have had the opportunity to help in this situation," the statement read.

Doug Tracy said he appreciates all the support his family received. Friends used Facebook and other outlets to garner national attention for the story, which Tracy said put a lot of pressure on Blue Cross Blue Shield. "I think they realized this is not going to go away," Tracy said.

Blue Cross Blue Shield would not say what prompted its decision, citing privacy laws. The issue is sensitive, Jarvis said, but the company is committed to providing affordable coverage whenever possible.

Tracy said that the money that people raised through benefit concerts and contributed to a fund to pay for Houston's medical bills will be donated to Cook Children's Health Foundation.

The Tracy family is an example of a pervading philanthropic spirit that exists at Cook Children's, said Gary Cole, vice president for development for Cook Children's.

"In a time of personal need, this family is seeking ways to help others," he said. "This is the truest form of philanthropy, and we are most grateful for such acts of kindness and concern for our patients."

JAN JARVIS, 817-390-7664

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