Twenty years ago, the parents of a child like Jenna barely flinched when they encountered discrimination. From the moment a sympathetic obstetrician offered to whisk their little tragedy off to an institution, the family of a child born with Down's syndrome learned that all other doors--to schools, workplaces, society itself--would be closed to her.
Things have changed a great deal since then. Vince and Rosemary Palandri have been encouraged to believe in their three-year-old daughter, and caring experts stand ready to help Jenna reach her potential. "I don't think it's right to use the words `disabled' or `handicapped' to describe her," Rosemary Palandri says. "She does face extra challenges, but anyone who knows her knows she's much more normal than not normal."
Such words reflect more than parental pride.
Scampering around in her blanket sleeper--talking, playing and trying (with mixed success) to manipulate her mother--Jenna is like any other cuddly toddler, as irresistible as an elf and equally full of mischief. Even the physical characteristics of Down's syndrome, almond-shaped eyes and short fingers, lose their distinctiveness on this alert, busy baby.
Was there really a time when people called such children "mongoloid idiots" and sanctioned the institutionalized prejudice they faced at every turn? The Palandris certainly had been led to believe they could expect better for Jenna, as have most parents of children with Down's syndrome born in the fifteen years since federal law outlawed most forms of discrimination against the handicapped.
Perhaps that is why the Palandris were surprised to discover that within the multimillion-dollar health insurance industry, both idiocy and prejudice live on.
They never saw what was coming when the nice lady at Blue Cross & Blue Shield of Arizona suggested last year that, instead of paying a past-due premium on their health insurance, they let their policy lapse. They could apply for a new policy, she said. It would save the extra expense of paying the back premium, she added helpfully.
When the Palandris decided not to fight for their existing policy, it gave the giant insurance company the opportunity to dump Jenna from its rolls. "After we did as we'd been advised and reapplied, BCBS told us they'd be happy to issue us a new policy--but not for Jenna," Rosemary Palandri says. "They said she was uninsurable. They also refused to reinstate our old policy."
No amount of arguing would move the company, the largest health insurer in the state, to reconsider. And no other insurance company they contacted felt any differently, says Jenna's mother. "Down's syndrome is an automatic turndown in Arizona," she recalls hearing again and again.
Few insurance companies will admit as much up front. The head of medical affairs for BCBS initially told New Times his company does not automatically reject children with Down's syndrome and reviews each individual's health record before making a decision. And four of nine companies surveyed recently by the state director of insurance, Susan Gallinger, asserted they also do not consider Down's syndrome grounds for automatic denial.
The families of these children hear a very different line, however, and they sometimes hear it in pretty demeaning terms. "When I insisted on knowing why my employer's insurance carrier refused to cover our son, the company president told me `because retarded people aren't worth insuring' and to quit bothering his agents about it," says Nancy Morgan, mother of a nine-year-old boy, Danny, with Down's syndrome. Morgan, as it happens, works for an agency providing support services to the parents of disabled children, but it made no difference to the insurer.
BCBS officials claim they are justified in refusing to insure Jenna because medical statistics show that children with Down's syndrome have a higher incidence of heart defects and other illnesses. "The law only prohibits unfair discrimination," explains Dr. Laurence Linkner, BCBS senior vice president for medical affairs. "All health insurance underwriting is discriminatory by nature because it's based on assessing the increased health risk posed by different groups."
The doctors who treat these children, however, believe the statistics are being misused. "Once you rule out congenital heart defects, which can be done at birth or soon after, the increase in health risk drops off to nearly nothing above normal," says Dr. Harold Magalnick, a north Phoenix pediatrician who currently sees around ten patients with Down's syndrome. "To put these kids at issue with regard to health insurance is ridiculous."
However, BCBS just takes the statistics at face value. Although the company carries an unknown number of children with Down's syndrome under the no-questions-asked policies negotiated by some large employers, it does not examine its own files to determine the actual cost of insuring this group. What's more, BCBS officials refuse to consider the individual health records of such children until the applicants reach the age of ten--when, according to medical literature, the increased incidence of health problems subsides.