Monday, November 2, 2009


Posted on OCTOBER 14, 2009:

Hoping against HOPE, state GOP sit quiet on insurance coverage for autistic

By Arnold Hamilton

The Chicken Littles were out in force recently at the state Capitol. One
after another, they traipsed before a House committee to warn of cataclysmic
consequences if voters approve SQ 744, the Oklahoma Education
Association-sponsored initiative that would require lawmakers to fund public
schools at the regional average.

It was a made-for-TV drama, which was produced and directed by Republican
legislative leaders who -- for the most part -- despise the OEA, the state's
largest teachers' union and the driving force behind the collection of
240,000 voter signatures that ensured the initiative appears on next year's
general election ballot.

Lawmakers didn't need to have staged two days of sky-is-falling hearings.
They already knew the abysmal revenue and budget numbers and the potential
impact of SQ 744. The truth is: They summoned agencies from across state
government to wail publicly about possible layoffs and service cuts as a
preemptive strike against the initiative, fearing its passage will
strengthen and embolden the OEA.

Actually, the legislative leadership's focus on SQ 744, also known as the
HOPE -- Helping Oklahoma Public Education -- initiative, is quite revealing.
Their No. 1 priority: Amassing and maintaining political power.

If it weren't so, they would be staging public hearings, and engaging in
vigorous public debate, on an issue that threatens to dwarf the $850 million
they claim the HOPE initiative would cost the state.

The pink elephant under the Capitol dome? Autism.

For more than three years, parents of children with autism have lobbied
state lawmakers -- unsuccessfully -- to require insurance companies to cover
treatment. Insurers, and their legislative allies, insist the costs would be
back-breaking. Meanwhile, families across Oklahoma are going bankrupt as
they scrape together every last penny for treatment that gives their
autistic children a fighting chance at a productive adulthood.

How does this impact the state budget?

In Oklahoma, about 500 children are diagnosed with autism each year.
Eventually, they will become adults, many eligible at age 18 for government
aid ranging from Social Security-related benefits to Medicaid. Their life
expectancy is the same as those without autism, and recent studies indicate
it costs about $3.25 million to care for autistic adults, not including

Federal and state governments will share the burden, but it's not difficult
to imagine -- given that 1 in 100 children are now being diagnosed with the
disease -- that autism could end up costing Oklahoma taxpayers in excess of
$1.5 billion a year or about one-fourth of the entire state budget.

Eighty percent of the Oklahoma children already diagnosed with autism are
younger than 16, meaning a perfect storm could be brewing: The oldest will
be reaching adulthood at about the same time as Baby Boomers begin tapping
Social Security and government health care programs.

"The first big wave is coming at us," said Edmond's Wayne Rohde, whose
11-year-old son Nick suffers from autism.

This is classic cost-shifting. Insurance companies calculate it's less
expensive to pour thousands of dollars into the campaign accounts of
sympathetic lawmakers -- those who will oppose any new coverage mandates --
than it is to cover autism, even though they'd probably just raise premiums
to protect the bottom line anyway. Moreover, why would an insurance company
willingly provide coverage for anything when the taxpayers are eventually on
the hook?

It won't make any difference to the current crop of legislative leaders who
are all-too-happy to do Big Insurance's bidding. They're going to be long
gone -- thanks to term limits -- by the time the autism tsunami hits the
state budget. It'll be somebody else's problem.

This is a serious public policy matter -- Oklahoma's version of the health
insurance reform debate in Washington. The Legislature hasn't approved an
insurance mandate since Republicans took control of the House of
Representatives in 2004. The last mandate? Insurers were required to cover
annual mammograms for women.

The conventional wisdom is that efforts to force insurance companies to
cover autism are a strictly partisan dispute: Democrats support the mandate,
Republicans oppose it. The reality is different: The GOP leadership is
hooked on campaign contributions from the insurance industry, and it uses
the money as a hammer to keep legislative Republicans in lock-step on the

It's clear, however, that GOP leaders are less-than-confident what would
happen if the measure reached the floor of either house for a straight
up-or-down vote. They're not taking any chances. In fact, House Republicans
this year killed the measure in committee where fewer votes needed to be
controlled to ensure the outcome.

Whether the mandate can be revived next year depends in part on the
parliamentary kills of minority Democrats. More importantly, it depends on
the willingness of enough Republicans to recognize that sound public policy.
It will cost much less to invest in childhood treatment than it will to, in
effect, warehouse thousands of autistic adults.

Fifteen states already have recognized the wisdom of this strategy. They
know there is scant evidence that mandating insurance coverage for autistic
children will significantly increase premiums or the number of uninsured.
What it does is protect families from bankruptcy and taxpayers from an
unnecessary burden.

And it ensures that thousands of lives won't be wasted: According to
studies, half the children that receive early, aggressive and consistent
intervention have most of their symptoms erased by grade school age.
Further, many won't end up needing to be placed in special education

Pay now or pay later.

-- Arnold Hamilton is editor of The Oklahoma Observer

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