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Insurance for youth sports: Game over?

Jon Butler was on the other end of the field when the pyramid collapsed. The knee of the cheerleader on top hit the neck of a cheerleader on bottom. By the time Butler, the executive director of the Pop Warner Athletic program nationwide, ran over, the Emergency Medical Technician (EMT) had already put a cervical collar on the injured girl's neck. But her mother was trying to take it off so her daughter could continue to compete.

"I said, 'No way!'” Butler recalls. "She has to be cleared by a medical professional before she can take the field again."

Are you tough enough?

It's rough on that field. Not just for the kids, but for the coaches, teachers and administrators who run school athletic programs. They butt heads with over-zealous parents who are more than willing to let their children "play hurt" in order to vie for scholarships. They get bad publicity when there's an injury or complaint about a coach. And they have to pay insurance companies ever-bigger premiums -- while school budgets shrink and volunteer contributions dwindle.

insurance for youth sportsThe NFL recently made headlines with its $765 million settlement with former players and their family members for concussion-related injuries. But it's the cash-strapped youth league coaches and teenagers already running laps around high school tracks who face the biggest problem.

The Lystedt Law

For Butler and the Pop Warner league -- which enrolls boys as young as age 5 in its football program and offers dance and cheerleading for girls -- one way to reduce injuries is to limit contact between opposing players during practice by spacing players out so they don't go head-to-head. Even the NFL no longer allows tackling in preseason practices.

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Since referees don't work for the league, Butler and Pop Warner abide by the Lystedt Law, named for the youth who sustained multiple concussions when he repeatedly returned to the game during a junior high school contest in 2006. He remains partially disabled. That Washington state law, which is also a guideline of the American Academy of Neurology, requires medical clearance for any athlete suspected of suffering a traumatic brain injury (TBI), thus taking the decision away from coaches and parents.

Suffer in silence

TBIs are not the only injury young athletes face, since many accidents occur off the football field. Soccer injuries are very common and girls who play competitively experience eight times more knee injuries than boys. There is a huge number of sports accidents overall, with 1.35 million children being seen in emergency rooms for them each year, according to the nonprofit advocacy group Safe Kids Worldwide, a coalition of doctors, nurses and other health care professionals.

Nearly half of these are concussions, with 62,000 a year in Arizona alone, according to that state's Brain Injury Association. They are dangerous because they are "silent" injuries. Only 5 percent of the time does a child lose consciousness or have to be carted off the field, according to a study cited by the National School Boards Association. The rest have "their bell rung," a synonym for ringing in the ears, and experience dizziness or nausea. Repetitive concussions affect younger children the most, even when their parents may think they are healed.

"It's like the dummy in the crash car who's not wearing a seat belt," says Butler. "You see him bounce back and forth. This is what happens to your brain inside your skull."

Does it pay to play?

Insurance companies won't discuss rates for medical accident and general liability insurance, both of which are required by Pop Warner and other amateur athletic organizations. But Butler says they are rising “steeply” and that coverage requirements are increasing.

In Pop Warner, each team is covered for up to $100,000 for each accident. That coverage includes anything that’s required: treatment on the field, in the hospital, even a Med-Evac helicopter if it’s necessary. Its general liability policy, which most businesses use to cover anything that might happen on the field or off, now includes $1 million for sexual molestation. Insurers insist on this because of the Penn State University scandal.

The biggest problem for Butler and other amateur athletic organizations is that their medical policies have become responsible for more and more children. If a young athlete is injured, his family’s health insurance is primary, which means it should be the first to pay. But many families now don't have health insurance, pushing the cost onto Pop Warner’s insurance. The number of uninsured kids has gone from 10 percent just a few years ago to 40 percent, says Butler.

The insurance burden on schools and amateur athletics has become so severe that “some schools and leagues may even shut down teams," says a New York Times story, while a Los Angeles Times article says that diving boards are now a "rarity" at most schools in California. The Robert Wood Johnson Foundation says the percentage of high schools with no sports nearly doubled to more than 15 percent in the first decade of the century.

"Whether coverage is affordable is a question to be resolved by school officials," says Robert Hartwig, president of the Insurance Information Institute, which represents the industry. But he warns that school districts need to ensure there are no gaps in medical coverage that could leave them vulnerable if a student is seriously injured.

Injuries better than obesity

From an insurer's point of view -- and only a few provide medical accident coverage -- there is a lot of news to scare them. Year-round sports programs run by for-profit companies, where child athletes focus on just one sport, create more potential for injuries than children who play multiple sports, says Butler.

Recent NFL injuries and suicides have shown that TBIs can show up years after the incidents occur. Helmet makers such as Schutt Sports warn that while helmets stop skull fractures, they don't protect against concussion. Football concussions more than doubled between the years 2000 and 2010 among 10- to 14-year-olds, according to ESPN, which described youth leagues as the "wild west" of sports. Some leagues even force athletes to sign waivers saying they won't sue if hurt.

There is plenty to scare parents, too, but probably nothing as much as inactivity: Not allowing their children to play sports at all. Childhood obesity has tripled in adolescents during the past 30 years, according to the Centers for Disease Control, and now encompasses more than a third of that population.

Injuries aside, nearly everyone agrees that sports are good for children. It's really a question of how we afford, and insure, them.

More from Ed Leefeldt here

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