Parents seek autism insurance mandate

The Journal Record
Sept. 19, 2008

OKLAHOMA CITY – Wayne Rohde and his wife spend $5,000 per month on treatment and therapy for their son Nick. They spend another $1,000 per month in premiums for a health insurance policy that does not – and will not – cover the bulk of their medical expenses. Nick has autism, and his treatments are not covered under the family’s health care policy.

It doesn’t take a mathematician to figure out why the family has considered dropping their insurance coverage, said Rohde. Money is tight, and the policy does not cover the one item they need coverage for the most.

But Rohde believes the private market, not socialized medicine, is the best way to handle health care in the United States. That’s why he’s working so hard to get the state government to force insurance companies to cover health expenses related to autism. Mandating coverage for autism will not destroy private insurance, he said – it will help preserve it.

“I come from a financial background,” said Rohde. “I worked on the campaign when Ronald Reagan ran for president … I’ve been around enough to know how these things work, and health care is best handled by the private market, not the government. But more and more of these health care costs are being shifted onto the taxpayers.”

When insurance companies fail to pay for medical treatment for autistic children, the parents turn to state services for help. Further, when insurance companies refuse to cover treatments proven to help autistic children grow into productive members of society, those children may instead grow into individuals who have to rely on state services for the rest of their lives.

Rohde is a central figure in a debate that has raged at the state Capitol for more than a year. He and other parents of autistic children are lobbying lawmakers to create a mandate, requiring insurance companies doing business in Oklahoma to cover medical costs related to autism. The state has created insurance coverage mandates in the past, including requirements for ambulance transportation and mammography screening.

Opponents of insurance mandates, who include the state House Economic Development and Financial Services Committee chairman, state Rep. Ron Peterson, R-Broken Arrow, say mandates may lead to the demise of the private insurance market. Requiring insurance companies to cover specific treatments and conditions drives up the cost of insurance for everyone, Peterson has said. Many families can barely afford to pay their insurance premiums, and any additional cost increases will price insurance coverage out of reach for more Oklahomans, leading to an increasing uninsured population.

Jim Nicholson, director of the developmental disabilities division of the Oklahoma Department of Human Services, said the situation does seem to be one of pay now or pay more later. The sooner children with autism are diagnosed and begin treatment, the better the outcomes for that child, with some children even recovering completely. The opposite is also true – children who do not receive treatment have more severe social, mental and physical problems when they grow up.

Dee Blose, mother of an autistic child, said she had heard someone make the comment during the 2008 session that “the cost is too much and the benefit is not worth it, since these kids will need to be institutionalized anyway.”

“That is not true,” said Blose, after introducing the committee to her 19-year-old son, David. Though David has trouble communicating, he spoke a few words at the meeting and will soon be moving out to live in his own house, three doors down from his parents.

Rohde said his son is responding well to the treatments and therapy he receives, and is doing a little better every day. Though Rohde said the sacrifices are well worth it, the situation has taken its toll on the family. Lack of support from their insurance companies on the autism issue is leading to a host of other societal ills.

“We’re bankrupt,” said Rohde. “We’ve used 20 years’ worth of retirement savings, and we have no idea what we’re going to do in 15 years when we’re scheduled to retire. … My marriage is a mess – we’ve done nothing wrong, we’ve just been unable to spend the time on it.” The divorce rate for parents of autistic children is 85 percent, studies show.