Thursday, October 21, 2010

NY Governor vetoes bill to mandate autism health-insurance coverage

Gov. David Paterson has vetoed legislation that would require state-regulated health-insurance companies to cover “evidence-based, peer-reviewed and clinically proven” treatment and therapy for people with autism spectrum disorder, saying it would amount to an unfunded mandate because it would increase health-insurance premiums state and local governments pay and the premiums for Child Health Plus, a government insurance program for children whose families are not eligible for Medicaid. The total annual cost of the legislation could be $70 million, according to the governor, and the state budget does not include money to pay for that.

The cost of commercial health insurance would also grow if the legislation were implemented, and could lead to loss of coverage for some New Yorkers, he said in the veto.

The state has a number of programs that provide early intervention for children with autism and other developmental disorders, although many families have to pay a significant amount of money each year to get all the services they believe their children need.

Paterson, who has about two months left in his term, wrote that he is “extremely sympathetic to the very real struggles faced by families of individuals” with autism spectrum disorder, which he said is a priority for society to address. Autism spectrum disorder, which occurs in roughly one out of every 100 kids, is characterized by difficulty with speech and social interaction and repetitive behavior patterns. Symptoms vary depending on where children are on the spectrum .

“It will be a subject of my continued advocacy as a private citizen. But now I am governor, and I cannot sign a bill that would impose costs that the Legislature does not fund,” Paterson wrote.

The bill has been the subject of intense lobbying by autism advocates who support and those who oppose the legislation. It was sponsored by Sen. Neil Breslin, D-Delmar, Albany County, and Assemblyman Joseph Morelle, D-Irondequoit, Monroe County.
Opponents said it would hurt people seeking treatment for autism because of the “evidence-based, clinically proven and peer-reviewed” standard, which is not required for other medical problems, and would shift costs from insurance companies to counties and taxpayers for early intervention services.

The governor said another flaw in the bill is it would require the state Health and Insurance departments and a few other state agencies to develop regulations for health insurers within a year and update them regularly, but the state budget does not provide them with the extra resources they would need to do this.”

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