The Unwanted Ones

Page 3 of 6

Despite the letter of warning they'd received years before, the Palandris say they had no idea BCBS would reject their daughter automatically. They thought Jenna's excellent health record would speak for itself. Whatever the statistics say about children with Down's syndrome, Jenna had not drained the corporate coffers as company officials claim such children are prone to do.

She was not among the 30 to 40 percent who are born with a malformed heart, the most serious health problem commonly associated with Down's syndrome. She did not experience multiple upper respiratory or ear infections, another area in which statistics show an increased incidence. Was BCBS worried she would develop leukemia, as do about 1 percent of children with Down's syndrome?

"I made it clear to BCBS we'd take a rider on the policy to exclude any problem related to Down's syndrome," Rosemary Palandri says. "They were adamant. One supervisor told me, `You can come and talk to whoever you want, it won't make any difference.'" What was it, then, that made this child uninsurable, and why was her record of good health discounted?

When New Times originally interviewed the company's top executive for medical affairs, prior to learning the Palandris had experience with BCBS, specific questions about the policy toward children with Down's syndrome brought the following responses:

"We do not tell people not to apply if they have a Down's syndrome child," Linkner said. "We will accept an application and we have insured families with Down's syndrome children and they are on our rolls now.

"We never deny coverage or [exclude the family member with Down's syndrome] without getting a medical record," Linkner said. "We always give a specific reason for rejecting an application.

"We're rather confident about what we do in terms of fairness," he added, glancing at his lapel pin commemorating the company's fiftieth anniversary in Arizona. "We're celebrating our fiftieth year this year; we didn't stay in business that long by hurting people."

In letters to the Palandris, however, BCBS was unequivocal in rejecting Jenna and refused to provide a specific health-related reason. "As a matter of corporate policy we do not release underwriting files to the public, but Medical Affairs Underwriting Guidelines preclude acceptance of a Down's syndrome child less than ten years old," wrote Stacy Augustine, a BCBS lawyer, in a September 16 letter to the family.

Nancy Morgan, who once worked for BCBS in Chicago, says she also got the brush-off. "BCBS was the first company I called when we moved out here," she says. "I had good feelings about them, but when they learned Danny had Down's syndrome they told me not to bother applying, they wouldn't even process the application."

Asked to explain the discrepancy between his original assertions and the Palandris' and Morgans' experiences, Linkner says, "You asked about our policy toward children. We in fact do have Down's syndrome children in our contracts, but to me `children' connotes something different than `infants.'"

Jenna Palandri's record of good health was disregarded, he says, "because our guidelines draw the line at age ten; we don't consider individual health records for applicants below the age of ten. Instead, we go by what the medical literature says are the risks."

Initially, the Palandris were mystified by the company's actions. "Usually, professional people are good about Jenna," says her mother. Certainly the health care professionals who treated Jenna all seemed to understand Down's syndrome and to take it in stride.

Not until the Palandris had to go shopping for health insurance, they say, did they confront truly dense ignorance about the condition. Other families, particularly those who pressed uncomfortably close for reasons their children were encountering such arbitrary denial, report similar experiences.

Vicki Stum, whose two-year-old son has Down's syndrome, says she received countless rejections when she attempted to replace coverage lost when her husband's employer folded last year. As with Jenna Palandri and Danny Morgan, the Stum child did not have a history of devastating (and devastatingly expensive) health problems.

"I called between 35 and 50 agents," Stum says. "Some of the agents I talked to thought it was a disease, some thought he'd outgrow it. The amount of ignorance was incredible.

"When I pressed to know why these underwriting policies discriminated against children with Down's syndrome, one agent, sort of groping for an explanation, said, `Well, you wouldn't want to buy a car with a ding in it, would you?'" Stum recalls.

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Kathleen Stanton