Dr. Jepson to lecture ASD

The Edmond Sun

Jepson to lecture on Autism Spectrum Disorders

In its second year, the Practice & Policy Lecture Series brings Dr. Bryan Jepson to open a dialog on the causes and treatments of Autism Spectrum Disorders at noon Feb. 11 at the Oklahoma History Center, 2401 N. Laird Ave., Oklahoma City.

He will discuss the current theories and research findings on causes and recommended treatments of autism. He also will discuss the medical treatment approach to autism rather than behavioral approaches. Jepson began investigating autism after his son was diagnosed with the disorder in 2001.

Jepson works for Thoughtful House Center for Children in Austin, and devotes his efforts to both the treatment and research of autism.

For more information, call the OKDHS Office of Planning, Research and Statistics at 521-3552. For more information on upcoming lectures and archives of previous lectures, visit the Practice and Policy Lecture Series Web site at: www.oucpm.org/lectureseries/.

Gumm: OSEEGIB Autism Cost Study Shows Minimal Impact on Insurance Rates

Oklahoma State Senate
Senator Jay Paul Gumm, D-Durant
State Capitol Room 535A
Oklahoma City, Oklahoma 73105
(405) 521-5586

FOR IMMEDIATE RELEASE: January 30, 2009

Gumm: OSEEGIB Autism Cost Study Shows Minimal Impact on Insurance Rates

The State Agency Analysis Shows an Impact of 1% or Less
(For digital audio, go to www.oksenate.gov)

Sen. Jay Paul Gumm on Friday announced that another analysis of Nick’s Law shows that the proposal will have a minimal impact on insurance costs.

The Oklahoma State Education Employees Group Insurance Board this week released the findings of their study, which showed an impact to claims of 1 percent or less. Gumm said these findings are in line with those in a comprehensive study by Jim Bouder, which was presented to the Legislature in May.

“What we’re continuing to see over and over again is that the impact on premium costs is around 1 percent,” said Gumm, D-Durant. “It fits perfectly with the study by Jim Bouder, which we presented last year. They attacked his study, they attempted to impeach his credibility because he has a son with autism, but his numbers continue to be confirmed by independent study.”

Jim Bouder’s study indicated the measure would create only a 0.47 percent premium cost increase, roughly a tenth of the current rate of inflation. Gumm said OSEEGIB’s findings call into question the credibility of a House study showing costs increases as high as 20 percent.

“It really calls into question the accuracy of the House study showing such astronomic increases,” Gumm said. “All the studies, done independently and by individuals who don’t have anything to gain from this are showing an impact of around 1 percent.”

“This proposal doesn’t carry the possibility of huge rate increases, and this study removes the final excuse they have for not supporting this legislation.”

OSEEGIB Memorandum on Nick's Law

To:	Joe McCoy, CPA Dana Webb
From:	Trey Sarsfield, ASA, MAAA
cc:	Kelly Wilson, CPA Frank Wilson, CPA Timothy Nimmer, FSA, MAAA Justin Kindy, FSA, MAAA Colleen Thompson, FSA, MAAA Jennifer Becker
Date:	January 20, 2009
Re:	SB 1

Dear Mr. McCoy and Ms. Webb,

Per your request, Aon reviewed the proposed Senate Bill 1, titled "Insurance - Create Nick's Law," related to an expansion of autism coverage in the State of Oklahoma. We relied on information from the legislature's independent actuarial study, including the findings that autism incidence in Oklahoma is approximately 1 in 500 children under the age of 18, and that the annual cost of implementing coverage in accordance with this bill is a minimum of $18,000 per autistic child, with a potential cost of $40,000 per autistic child. Based on our calculations, the impact to claims will be an increase of 1% or less. Based on Aon's recent projection of $755 million for calendar year 2009 Medical and Prescription Drug claims, the estimated dollar impact is not expected to exceed $7.5 million. The minimum impact Aon would be comfortable using for pricing and budget setting is one-third of 1%, or approximately $2.5 million. Please note that the legislation could result in lower costs than this figure; we simply feel this is the minimum estimate we can provide as responsible actuaries and stewards of OSEEGIB's health plans.

If you need further information or have any questions, please do not hesitate to contact us.

Thanks,

Leonard (Trey) Sarsfield III, ASA, MAAA

Assistant Vice President

Aon Consulting

4100 E. Mississippi Ave, Suite 1500

Denver, CO 80246

Ph: 303-782-3328

Truth evaded in discussion of autism insurance coverage

Truth evaded in discussion of autism insurance coverage

By Robyne Rohde
State view

January 30, 2009 05:29 pm

— Thomas Jefferson, co-author of the U.S. Constitution, said in 1820: “We are not afraid to follow the truth wherever it may lead, nor to tolerate any error so long as reason is left free to combat it.”

When those in power are so afraid of the truth that they abandon reason and are willing to tolerate all kinds of errors in order to hide the truth, we all suffer and as in the case of the thousands of children with autism in Oklahoma. They suffer the most.

There has been much said about autism insurance coverage in Oklahoma, so as the parent of a child on the severe end of the autism spectrum and mommy to Nicholas Rohde, the child whose name is on Senate Bill No.1 referred to as Nick’s Law, I wanted the opportunity to correct many errors that have been told to Oklahomans about Nick’s Law and hope in doing so the people of Oklahoma will “... follow the truth wherever it may lead ...”

Truths
• The root problem for families with autism is the inability to pay for services.
• Autism is a medical condition that covers a spectrum of symptoms. In some cases children are so mildly affected they may never be diagnosed or severely affected as with the case of our son, Nick. Nicholas has lost the ability to speak, suffers from severe gastrointestinal issues, eating disorders and self-injurious behaviors. Many children also suffer from seizures.
• Autism affects the entire family and 80 percent of these families end in divorce.
• More children are diagnosed with autism than all pediatric cancers, diabetes and Aids combined, according to the Centers for Disease Control and Prevention (CDC). Every one in 150 children in our state suffer from autism (using the CDC’s1992 figures) with boys affected four times more than girls. It is estimated there are 7,500 children and adults in Oklahoma with autism.
• Insurance rates will not rise or will rise minimally ($1.66 per policy holder) with the passage of Nick’s Law, per an independent actuarial study. The reason the rate is so low is that this mandate will be spread among all policy holders within a group policy risk pool.
• Without treatment, when these children become adults at 18, they will become wards of the state, with each and every taxpayer in Oklahoma picking up the tab to care for children who for all intents and purposes will not be able to communicate or perform their most basic needs. The lifetime cost to care for an untreated person with autism is $3.6 million.
• The market/demand theory for highly skilled services (e.g., Board Certified Behavior Analysts (BCBA’s), tutors, occupational, physical and speech therapists) has not and will not work in response to the demand because of the inability of the families to pay for these services.
• There hasn’t been an insurance mandate since 2001, yet insurance rates have continued to rise as have deductibles.
• The state House of Representatives conducted numerous interim studies that only focused on state services for children with autism and never addressed insurance coverage.
• In Oklahoma, insurance mandates are not the reason for the high rate of uninsured. Missouri has roughly the same insurance rates as Oklahoma, and they have more mandates than our state and Missouri’s median income and percentage of uninsured is considerably less than Oklahoma’s. Our state Legislature continues to equate higher mandates with an increase in insurance premiums. This simply isn’t true.

Errors
• The root problem for families living with autism is lack of services such as BCBA’s.
• Autism is a mental/psychological condition.
• There are churches and private organizations that will pay the 7,500 families living with autism in Oklahoma $65,000/year for the therapies their children must have to become independent adults.
• The schools in Oklahoma are equipped to provide the needed therapies these children must have to become independent adults.
• Allowing young adults to purchase mandate free group insurance policies will decrease the number of uninsured.
• Specialized autism practitioners will come to our state, even though there is no income stream available to pay these practitioners.
• Taking time for the market to respond to the demand of services is more likely to provide real hope for effective treatments.
• An autism insurance mandate will increase insurance rates.
• State-funded services will provide families with the services they need.
• Nick’s Law will increase the uninsured in Oklahoma.

After reading the above, I hope you will “follow the truth” and realize Nick’s Law is simply, the right thing to do. The misinformation that has been disseminated by our state Legislature is appalling. We are losing generations of children to this disease and while research is needed, it is more important, to address the children who can be helped now and in some cases be cured using medically necessary interventions. With treatment, our children can become independent, taxpaying adults rather than wards of the state.

In Oklahoma, the political process has become a government of "special interests," where those with the most money end up receiving the most benefit and protections of state government. The thousands of families living with autism in Oklahoma do not have millions to give to our politicians. Our lobbyists are mommies, daddies, grandparents and family members. Every cent we have is spent on our children with autism.

During this historic political year, I’ll leave you with another quote from a document that our country has used as the basis for the rights of all Americans for over 200 years, The Declaration of Independence:

“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights that among these are Life, Liberty and the pursuit of Happiness.”

Unfortunately, our forefathers didn’t realize someday we would have an epidemic of millions of children suffering from autism that our elected officials have chosen to ignore. Because of the discriminatory practices of big insurance in Oklahoma and the legislators who continue to protect special interests, rather than our children, the rights afforded to every American do not apply to children diagnosed with autism. Therefore, the unalienable rights of life, liberty and the pursuit of happiness is not an option in Oklahoma for families living with autism.

Robyne and Nicholas Rohde live in Edmond.

Copyright © 1999-2008 cnhi, inc.

Senator says autism costs minimal

Senator says autism costs minimal

By The Associated Press
Tim Talley
1/30/2009

OKLAHOMA CITY — A study by a state group insurance board indicates that a proposed health insurance coverage mandate for autism would have little impact on insurance costs, a state senator said Friday.

Sen. Jay Paul Gumm, D-Durant, said the study by the Oklahoma State and Education Employees Group Insurance Board showed an impact to premiums of 1 percent or less and supports a study released last year that said the measure would create only a .47 percent premium cost increase, roughly a tenth of the current rate of inflation.

Gumm, author of an autism mandate bill, said OSEEGIB's findings also called into question the credibility of a study by the Oklahoma House that said an autism coverage mandate would increase rates by at least 7.8 percent and possibly as high as 19.8 percent.

House Republican leaders have opposed the mandate legislation and claim it will drive up insurance costs. Instead, they have proposed a plan to increase the number of therapists for autistic children in the state.

"All the studies done independently and by individuals who don't have anything to gain from this are showing an impact of around 1 percent," Gumm said. "This proposal doesn't carry the possibility of huge rate increases, and this study removes the final excuse they have for not supporting this legislation."

Gumm has filed mandate legislation known as "Nick's Law," named for an 11-year-old autistic boy from Edmond, Nick Rohde. The same bill was passed by the Senate last year but was repeatedly blocked by GOP

House leaders.

Nick's father, Wayne Rohde, said the latest study validates claims by the parents of autistic children that a mandate similar to others in about 20 states, including Texas, would not significantly raise insurance rates.

"Nick's Law as presently written has very insignificant costs and probably would be absorbed into the system," Rohde said.

Autism is a bioneurological disability that affects communication skills in young children, many of whom also suffer from ailments such as allergies, asthma and epilepsy. Officials estimate it affects about one out of every 150 children.

Rohde has said he spends $5,000 a month for autism therapies for his son and another $1,000 a month for a health insurance policy that does not cover autism. Refusing to require health insurers to cover the diagnosis and treatment of autistic children places the ultimate burden of caring for them on taxpayers, he said.

"It will save the taxpayer lots of money. And it will actually save these children, too," he said.

House Speaker Chris Benge, R-Tulsa, was not immediately available for comment Friday evening, said Jennifer Monies, the House's communications director.

Meanwhile, the author of a similar autism mandate bill in the House expressed pessimism that the bill will be kept alive when it is heard by the House Economic Development and Financial Services Committee on Tuesday. The GOP autism plans is also scheduled to be heard by the committee on Tuesday.

Democratic Floor Leader Mike Brown of Tahlequah said the hearing is "a grudging shuffle in the direction of fairness" that is the result of political pressure exerted by the families of autistic children.

"Unfortunately, the Republicans have already made up their minds to kill this bill before they've heard it," Brown said. "The Republicans claim to sympathize with the plight of these families, but how sympathetic can they be if they won't respond to their one requests?"

Majority has chance to make a statement Open Quote: Glenn Coffee

The Oklahoman, January 26, 2009

Sen. Glenn Coffee, R-Oklahoma City, was recently chosen as the first Republican President Pro Tem of the state Senate. He visited with The Oklahoman’s editorial board to discuss issues important to the Senate, which for the first time has a majority of GOP members.

Adding more (health care) mandates is just putting more strain on the system to cause it to fail. Among states, we’ve got this higher rate of uninsured and I think it’s exactly the wrong direction to go until we can get an affordable plan that we can encourage participation in. There are some things that can be done. My belief is there will be an autism bill that addresses what issues there are that the research says are important. ... There are a lot of states that have done this in a more reasonable fashion, and hopefully we’ll get there.

To read the entire article, click here

[ Opinion ]

Updated: Thursday, January 22, 2009

The Steele Report By State Rep. Kris Steele The increased diagnosis of autism in society has fueled a debate about the best way to address the problem and help children with the condition. On one side are proponents of a political proposition that places bureaucrats and politicians in charge of medical decisions. The other side suggests efforts should focus on addressing infrastructure needs and allowing the market to efficiently and deliberately allocate resources for the maximum benefit of all. The political proposal is not without appeal. It offers an easy and swift reaction that on the surface sounds like a good thing, although it would only benefit a fraction of the families it professes to help. Building the infrastructure and allowing the market to respond are more likely to provide real hope and effective treatment with tangible benefits to children with autism without adding to number of uninsured. Last year, the Oklahoma House of Representatives identified numerous unanswered questions surrounding this issue and opted to conduct an in-depth study on autism and commissioned an actuarial analysis to determine the true costs of a mandate. The wisdom of that action has been validated in recent months. For instance, a leader in the private sector responded to the needs of Oklahoma families by announcing the addition of a market-driven autism benefit that will cover evaluations and management procedures as well as speech, physical, and occupational therapies. The professionals involved in that decision indicate the new benefits will provide significant services to children with autism without a dramatic spike in insurance rates. In addition, the interim study afforded the opportunity for the Legislature to address the root problem facing Oklahomans with autism - a lack of service providers. A recent state pilot program providing families over $12,000 to obtain autism-related services resulted in much of the money remaining unspent because there were not enough professionals to meet demand. That is why House Republicans will seek to develop and enhance the network of providers by instituting a state license for national Board Certified Behavioral Analysts. Implementing appropriate accountability measures will define the practice and protect Oklahoma families against exploitation by untrained professionals posing as "autism therapists." In addition, our initiative will seek funding for an applied behavioral analysis (ABA) Research Pilot Project that will provide supervision for students seeking licensure and determine the effects of qualified ABA. Our plan will also enhance current services by providing autism evaluation training for family doctors, specialized autism training for Sooner Start providers, and a parental training component that will empower families to continue therapies at home to supplement treatment and reduce expenses. The needs of families affected by autism are very real and often heartbreaking. The love of these caring parents is just as real and their worry about the future is intense. I understand the frustration many experience with the legislative process, but real solutions take time. We are experiencing genuine progress in the battle against autism in Oklahoma and the beneficiaries are the families of children with the disorder.

Cooksey, McDaniel support autism plan

Cooksey, McDaniel support autism plan

James Coburn
The Edmond Sun

EDMOND January 24, 2009 12:53 am

— Support for legislation targeted to increase the number of therapists for Oklahoma children with autism has the support of state House lawmakers Marian Cooksey and Randy McDaniel, whose districts include Edmond.

The representatives support legislation to increase the number of physicians trained to diagnose and treat autism. Universities would provide certified behavioral therapists specializing in autism.

“We want to help and make a better Oklahoma,” McDaniel said. “I think we both would want to help kids in need. And the more you learn about it, you realize it’s a big problem.”

Autism is a complex developmental disability that typically appears in children before age 3, according to the Autism Society of America. The neurobiological disorder hinders areas of the brain responsible for social interaction and communication.

One in 150 people has autism, according to the Centers for Disease Control. Most of these children are boys. Autism increases at a rate of 10 percent to 17 percent per year, according to the U.S. Department of Education. Eighty percent of these children are under age 14.

“It is a serious problem and I know they need help,” Cooksey said. “We are trying to see all of the areas we can help them without creating such an increase of insurance that would knock off so many other Oklahomans that cannot afford it.”

Blue Cross and Blue Shield of Oklahoma announced in December that autism spectrum benefits will be provided in 2010.

A BCBS overview provided to The Edmond Sun by Cooksey’s office states the autism benefit rate increase will be 0.22 percent to the entire block of business, or a 2.1 percent increase in the child rate.
BCBS benefits beginning at birth would end on a child’s sixth birthday. The annual maximum benefit is $25,000 and the lifetime maximum limit is $75,000. This benefit includes evaluation and management procedures, speech therapy, physical therapy and occupational therapy.

“Obviously if Blue Cross and Blue Shield, which is highly recognized, starts getting in, there will be other private competition for the best product,” McDaniel said. “And it can evolve into something that can make sense where we can actually provide the help.”

A deductible and coinsurance amount is not stated in the BCBS overview. An exclusion for behavioral therapy and experimental therapy is noted.

Behavioral therapy is 80 percent of the out-of-pocket expense that families dealing with autism currently pay for their child’s care, said Wayne Rohde, whose son Nick lives with autism.

“None of us want people to do without the care they need,” Cooksey said. “But at the same time, we can’t just look at one area. We have to look at the whole picture and how we can handle that.”

An independent House and Senate study stated an autism insurance mandate would increase insurance rates by 7.8 to 19.8 percent.

In 2007, The Council for Affordable Health Insurance, a research and advocacy association of insurance carriers, reported insurance mandates regarding autism would increase the cost of health insurance premiums for consumers in 10 states by 1 percent or less.

The proposed Nick’s Law would provide insurance coverage for the early diagnosis testing of autism and medications until the child reaches age 21.

In March, Nick’s Law went to the House Economic Development and Financial Services Committee after winning Senate approval 39-9. Nick’s Law was blocked by the House committee’s chairman, Rep. Ron Peterson, R-Broken Arrow, when he denied giving it a hearing.

“We have a huge overriding goal. We want more people to have insurance,” McDaniel said. “Then, the other side of the table would say we have these different categories we need to ensure that they’re being taken care of.”

He said lawmakers must be prudent not to pass insurance mandates that most people cannot afford.

Funds from the Oklahoma Department of Human Services available for children with autism were not being used due to a lack of autism experts in the state, Cooksey said. This DHS pilot program was to involve 30 children combined from the Tulsa and Oklahoma City areas, McDaniel said.

“Somewhere between $8,000 and $12,000 per family was not spent,” Cooksey said. “We don’t have doctors that know that much about it.”

In addition, the proposed law would enhance Sooner Start for disabled children 3 years old or younger. And it would support privately-funded research efforts for autism.

“There will always be groups that want us to do more. In a tough (financial) year, I think we’re making a significant step forward and I feel good about us making good efforts,” McDaniel said.

In 2008, Cooksey assisted Rep. Ken Miller, R-Edmond, in passing legislation that provides funding for a master’s level teachers training program focusing on autism behavioral problems. Twenty-six teachers in the program are preparing to complete their first year of training, Cooksey said.

“They would be able to help diagnose the problems in school,” Cooksey said.

Autism measures set stage for major legislative battle
Partisan clash returns over insurance mandates

Published: January 19, 2009

Michael McNutt

House Democrats vow to continue trying to require insurance companies to provide treatment for autistic children in what likely will be a major battle this legislative session.

Leaders in the Republican-controlled House, who last year did not take up measures dealing with the growing number of autistic children in the state, are suggesting more therapists and specialists would be a better solution than mandated coverage.

"I’m gratified to see that the speaker is aware of at least some of the challenges Oklahoma families face in seeking care for their autistic children,” said Rep. Mike Brown, D-Tahlequah.

House Republicans are proposing enacting a licensing process for national board-certified behavioral analysts and expanding state programs that train doctors to diagnose and treat autism.

"Currently, there is a huge imbalance between supply and demand,” said House Speaker Chris Benge. "We have only a few true providers in Oklahoma, but potentially thousands of children needing services.”

Study cites shortage

During a 2008 House legislative study, lawmakers were told a shortage of trained providers has made it difficult for families to obtain autism services even when they have state assistance.

A pilot program that ended last year provided families $12,360 a year to obtain autism-related services. Much of the money went unspent because there were not enough professionals trained to work with children with autism, said Jim Nicholson, director of the developmental disabilities division of the state Department of Human Services.

"Focusing on increasing the pool of qualified service providers will avoid many of the frustrations experienced by people in other states of having greater access to services but finding no services to access,” he said.

Rep. Wallace Collins, D-Norman, said the House Republicans’ plan would be helpful, but most families still need some financial help to get services for autistic children.

"I’m heartened to hear that House Republicans are interested in increasing training for autism specialists, but what I want to know is, what are they going to do for families who need help now?” Collins said. "Do they expect parents of children with autism in our state to sit back and wait for ‘market forces’ to help their children?

"If we provide insurance coverage for autism in our state, then the providers will come to take advantage of it,” Collins said.

It’s unknown how many autistic children are in the state. According to the national Centers for Disease Control and Prevention, one in every 150 children in the U.S. is diagnosed with autism. It is considered the fastest-growing developmental disability. Research indicates early intervention can help.

Senate bill filed

Sen. Jay Paul Gumm has filed Senate Bill 1. It is similar to a measure that died in the House that would have required insurance companies to provide coverage of autistic children. He said the House Republican plan "falls short” of what is needed.

He said any strategy to help children with autism must include insurance coverage.

"Even House Republicans acknowledged during their interim studies the woeful lack of autism therapists in Oklahoma,” he said. "Every one of their proposals will cost taxpayers money. And the small amount they are willing to commit to this epidemic is wholly inadequate to meet the needs.”

Rep. Daniel Sullivan, R-Tulsa, said Oklahoma families primarily need therapists and behavior analysts to help their autistic children.

Building up services

"All the money in the world won’t help a patient who can’t find a doctor,” Sullivan said.

Gumm said progress is being made.

Parents of autistic children were kept twice last year from speaking to a House committee.

"With the passion and effort of these parents, we have dragged the House leadership from literally slamming doors in parents’ faces to offering a partial solution,” Gumm said.

Progress being made

Progress being made
POINT OF VIEW

Autism assistance in state

BY STATE REP. KRIS STEELE

Published: January 18, 2009

The increased diagnosis of autism in society has fueled a debate about the best way to address the problem and help children with the condition.

On one side are proponents of a political proposition that places bureaucrats and politicians in charge of medical decisions. The other side suggests efforts should focus on addressing infrastructure needs and allowing the market to efficiently and deliberately allocate resources for the maximum benefit of all.

Kris Steele

The political proposal is not without appeal. It offers an easy and swift reaction that on the surface sounds like a good thing, although it would only benefit a fraction of the families it professes to help.

Building the infrastructure and allowing the market to respond are more likely to provide real hope and effective treatment with tangible benefits to children with autism without adding to number of uninsured.

Last year, the state House of Representatives identified numerous unanswered questions surrounding this issue and opted to conduct a study on autism and commissioned an actuarial analysis to determine the true costs of a mandate. The wisdom of that action has been validated in recent months.

For instance, a leader in the private sector responded to the needs of Oklahoma families by announcing the addition of a market-driven autism benefit that will cover evaluations and management procedures as well as speech, physical and occupational therapies. The professionals involved in that decision indicate the new benefits will provide significant services to children with autism without a dramatic spike in insurance rates.

The interim study afforded the opportunity for the Legislature to address the root problem facing Oklahomans with autism — a lack of service providers. A recent state pilot program providing families over $12,000 to obtain autism-related services resulted in much of the money remaining unspent because there weren’t enough professionals to meet demand.

That is why House Republicans will seek to develop and enhance the network of providers by instituting a state license for national Board Certified Behavioral Analysts. Implementing appropriate accountability measures will define the practice and protect Oklahoma families against exploitation by untrained professionals posing as "autism therapists.”

In addition, our initiative will seek funding for an applied behavioral analysis (ABA) research pilot project that will provide supervision for students seeking licensure and determine the effects of qualified ABA.

Our plan will enhance current services by providing autism evaluation training for family doctors, specialized autism training for Sooner Start providers, and a parental training component that will empower families to continue therapies at home to supplement treatment and reduce expenses.

The needs of families affected by autism are very real and often heartbreaking. The love of these caring parents is just as real and their worry about the future is intense.

I understand the frustration many experience with the legislative process, but real solutions take time. We are experiencing genuine progress in the battle against autism in Oklahoma and the beneficiaries are not politicians seeking publicity, but the families of children with the disorder.

Steele, R-Shawnee, represents District 26 in the Oklahoma House.

Nick's Law Supporters Push for Insurance Mandate

Nick's Law Supporters Push for Insurance Mandate

Posted: Jan 14, 2009 06:18 PM
Click Here to view video

Supporters of Nick's Law say it might increase insurance premiums, but only minimally. They say 30 other state legislatures will be considering similar legislation this year.

By Alex Cameron, NEWS 9

OKLAHOMA CITY -- It seems one of the more contentious issues this coming session, just like last session, is going to be care for autistic children.

Not only will Democrats make a renewed push for Nick's Law, mandating insurance companies provide autism benefits, but House Republicans, who killed Nick's Law last year, are entering the fray with their own autism legislation.

The GOP is also hoping to make autism treatment more accessible. Without creating an insurance mandate; whether that's realistic or not is open for debate.

What House leadership wants to do is increase the number of qualified behavioral therapists in the state, and then let market forces bring down the cost of their services, and at the same time, increasing access to them.

"Through the course of our study, we determined that the place to start is with developing, growing that network of service providers, developing that infrastructure, and we believe that is an appropriate function of government," Kris Steele (R) District 26 said.

Wayne Rohde welcomes the GOP proposal, but the father of autistic Nicholas Rohde, the Nick's Law namesake, says it still won't get to the heart of the problem.

"It provides some of the support services, but we still haven't found the mechanism to pay for the services," Rohde said. "It's like building a home. They're providing the walls and roof, the foundation hasn't been laid."

The only way to do that, Rohde says, is through an insurance mandate, which, he says supporters of Nick's Law understand.

"They know that if they would pass the mandate, practitioners would flock to the state," Rohde said. "It's not the other way around. The reason why we don't have anyone here now is because they can't make a living."

Democrats also welcome the Republican initiative, but say it still comes up short.

"They are more interested in having it driven by market, which is going to take some time, and what we feel is, those people that have autistic children, they need help right now," Rep. Brian Renegar (D) District 17 said.

"We feel like that our plan is a more responsible plan in that it will help us address the problem immediately and in the long term without adversely affecting the cost of health care for everyone living in our state," Steele said.

That's the argument that opponents of Nick's Law make, that mandating autism benefits will drive insurance premiums up for everyone, meaning even more Oklahomans would be unable to afford insurance.

Ok House Democrats Welcome Republican Wake-Up to Autism

State of Oklahoma

House of Representatives

FOR IMMEDIATE RELEASE

Tuesday, January 13, 2009

Democratic Floor Leader Mike Brown

Representative Wallace Collins

Representative Ben Sherrer

Contact: Karina Henderson

State Capitol Building, Rm. 548

Oklahoma City, Oklahoma 73105

405-521-2711, x819

House Democrats Welcome Republican Wake-up to Autism

Oklahoma City (January 13, 2009) State Capitol – Several members of the Oklahoma House Democratic Caucus reacted to today’s press release from Speaker Chris Benge’s office regarding autism.

“My response is, ‘Welcome to the table, Speaker Benge,’” Brown said. “I’m gratified to see that the Speaker is aware of at least some of the challenges Oklahoma families face in seeking care for their autistic children.”

Rep. Wallace Collins, who pushed for the bill known as “Nick’s Law” to be heard in the House last session, also expressed willingness to work with Speaker Benge.

“If Speaker Benge would like to hear more about the legislation that Democrats have proposed to help families of children with autism, we are more than willing to sit down and fill him in on what we’ve been fighting for all this time,” said Collins.

“I’m heartened to hear that House Republicans are interested in increasing training for autism specialists, but what I want to know is, what are they going to do for families who need help now?” Collins added. “Do they expect parents of children with autism in our state to sit back and wait for ‘market forces’ to help their children?”

In today’s release, Speaker Benge noted that in our state alone, “potentially thousands of children” need care for autism and related health issues, but that the Republicans’ proposal is designed to “allow market forces to alleviate the costs of autism services and increase access to care”.

“I’ve always said on this issue that, ‘If you build it, they will come.’ If we provide insurance coverage for autism in our state, then the providers will come to take advantage of it,” Collins noted.

“It strikes me as odd that during last year’s Health Care Reform Task Force, the issue of challenges Oklahoma families face when their insurance won’t cover autism was never addressed,” said Rep. Ben Sherrer. “Even with today’s release, there’s still an elephant in the room – that without insurance coverage for autism and related issues, many families in our state still can’t afford to care for their children.”

In a recent report titled “The Child Advocate,” the Oklahoma Institute on Child Advocacy noted that autism is the “fastest-growing serious developmental disability in the U.S.,” and that it is “more common” among children “than pediatric cancer, diabetes and AIDS combined.” Yet many insurance companies refuse to cover care for children with autism.

“It just goes to show there remains an apparent priority to protect the insurance industry over Oklahoma families affected by autism,” Sherrer added.

Brown, for now, remains welcoming to Speaker Benge’s newly found concern for autism.

“I’m not going to ask where Speaker Benge was last year, when a member of his party refused to hear a bill to reform insurance companies’ discriminatory practices against autism. And I’m not going to ask where he was when he rejected pleas from his Democratic colleagues and families of children with autism to consider amendments on the subject. For the moment, I’m just happy that he knows autism is an issue we need to address.”