Thursday, January 1, 2009

Our opinion: Parents of autistic children need the reprieve of insurance coverage

Wichita Falls, TX
By Times Record News Staff
Thursday, January 1, 2009

If one out of every 200 children is diagnosed with a disease or illness, you’d think that particular medical crisis would be, could be covered under a family’s health insurance. For parents dealing with their child’s diagnosis of autism, that’s not necessarily the case. These parents face a lifetime of social awkwardness, at the very least, destructive obstacles at the very least.

According to the National Institute of Neurological Disorders and Stroke, children diagnosed with autism “have difficulties with social interaction, problems with verbal and nonverbal communication, and repetitive behaviors or narrow, obsessive interests. These behaviors can range in impact from mild to disabling.” The children often fail to respond to their name, avoid eye contact and have difficulty interpreting what others are feeling or thinking. They can’t understand social clues, the institute describes, and they lack empathy. They shouldn’t lack the resources to make their lives better.

One Oklahoma legislator wants to give parents of autistic children the resources they need to improve their future. Oklahoma Sen. Jay Paul Gumm, D-Durant, calls his measure “Nick’s Law,” after an Edmond, Okla., child who has autism. Gumm’s law would make all insurance companies cover autism, The Associated Press reported. His first attempt in the Oklahoma Legislature failed last spring. But he’s not giving up, and his passion has not been dowsed by one company’s pledge to cover children with autism.

Blue Cross and Blue Shield of Oklahoma announced this week the enhancement of autism benefits that include evaluation and management procedures, and speech, physical and occupational therapies. The benefit should be implemented, the company reported, in January 2010, not soon enough for countless families dealing with autism.Gumm wants the effort to take a step farther, by requiring all insurance companies to cover autism treatments.

If “Nick’s Law” becomes a reality, the Edmond Sun reports, the insurance would cover the early diagnosis testing of autism and medications until the child becomes 21 years of age. A financial cap would cover $75,000 of behavioral therapy per year. Sen. Clark Jolley, R-Edmond, doubts “Nick’s Law” will pass in the next session, the newspaper reported, and is concerned about forcing mandates on insurance companies. “When asking for an insurance mandate, it’s asking for coverage for something that not everybody needs,” Jolley said. “And you’re asking for everybody else to bear the cost of it, and that’s what universal health care is.”

Not everyone needs Viagra, but many insurance plans cover the prescription. Not everyone gets cancer, but thankfully insurance companies cover the treatment and recovery associated with cancer. These parents need a life line. They need their peers to understand the struggles they endure. They need the medical community to provide expert treatments that would improve their children’s lives. And they need the financial reprieve that insurance coverage would provide.

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