Lawmakers question erectile dysfunction coverage

FAIRNESS
Sen. Tom Adelson: He wonders why autism is not covered by insurance companies that cover erectile dysfunction.

By BARBARA HOBEROCK World Capitol Bureau
Published: 2/26/2009

OKLAHOMA CITY — Democratic senators are questioning why insurance companies can cover the treatment of erectile dysfunction and not autism.

The 22 Senate Democrats asked a state agency Wednesday to determine how much could be saved if the Legislature banned insurance companies that don't cover autism from covering erectile dysfunction.

The request was sent to Bill W. Crain, administrator of the Oklahoma State Education Employees Group Insurance Board.

"We have been told by Republicans that it is not fair for those who do not have autism to have to pay for coverage for those who do," said Sen. Tom Adelson, D-Tulsa.

"Why is it fair for those who do not suffer from erectile dysfunction to pay for those who do in the form of higher premiums? I would think most Oklahomans would rather have their premiums cover children with autism, rather than people with erectile dysfunction."

The state does not mandate coverage for erectile dysfunction but does mandate prostate screenings and exams, said Amber England, a spokeswoman for the Senate Democrats.

"We know insurance companies cover the treatment of erectile dysfunction," England said.

A bill to require insurance companies to cover autism died in the House and can't be revived for two years. A similar measure did not get a hearing in the Senate.

Adelson said Senate Democrats could amend a bill to ban insurance companies from covering the treatment of erectile dysfunction if they don't cover autism.

Sen. Jay Paul Gumm, D-Durant, said he has prepared two other amendments intended to help families of children with autism.

One would ban insurance companies that don't provide autism coverage from receiving state incentives, such as tax credits for creating jobs, Gumm said.

Another would make the state's health insurance "high-risk pool" cover autism, Gumm said. The high-risk pool is for those who can't get insurance anywhere else, he said.

Democrats want ED impact statement

Eds: UPDATES with details, quotes, no pickup.

By RON JENKINS

Associated Press Writer

OKLAHOMA CITY (AP) -- Oklahoma Senate Democrats said they are amazed that some insurance companies pay for treating erectile dysfunction, while denying coverage for autism.

All 22 Democrats in the 48-member Senate signed a letter on Wednesday asking for a cost savings analysis in the event lawmakers barred insurance companies from covering ED if they refuse to cover the diagnosis and treatment of autism spectrum disorders.

The letter was sent to Bill W. Crain, administrator of the Oklahoma State and Education Employees Group Insurance Board.

"It is our understanding that insurance companies will pay for you to buy Viagra but they won't cover treatment for autism," said Sen. Charles Laster of Shawnee, Democratic minority leader.

"We just think it is bad policy that insurance companies get away with covering such nonessential things as treatment for ED and yet they are being protected for having to provide treatment for autism," he added.

He said he was sure many would argue that ED treatment is not nonessential "but from a public policy standpoint, I think it is pretty minor when compared with the thousands of kids out there with autism."

"It's just a discussion of priorities. Is health coverage for ED more important than coverage for autism?" added Sen. Tom Adelson, D-Tulsa, former state secretary of health.

Bills to require autism coverage have died in House and Senate committees this session after opposition from Republicans who say such mandates will cause insurance rates to increase significantly.

Senate President Pro Tem Glenn Coffee, R-Oklahoma City, had no comment on the Democrats' latest tactic to keep the issue alive.

Members of the Democratic caucus plan a press conference Thursday during which they said they would "express frustration over Senate Republicans' disturbing pattern of protecting insurance companies on the backs of Oklahoma's working and middle class."

Sen. Jay Paul Gumm, D-Durant, is the main sponsor of the autism coverage bill that died in committee.

Gumm said he has an amendment planned for a tax bill that would prohibit insurance companies from qualifying for premium tax credits or job creation incentives if they do not cover autism.

He said he has prepared another amendment to require the Oklahoma High Risk Insurance Pool to cover autism.

He said neither proposal would be a mandate on private insurance companies.

Senate Democrats question insurance companies' autism policy

by: BARBARA HOBEROCK
Tulsa World Capitol Bureau
Wednesday, February 25, 2009
2/25/2009 9:35:09 PM

OKLAHOMA CITY — Democratic senators are questioning why insurance companies can cover the treatment of erectile dysfunction and not autism.

The 22 Senate Democrats on Wednesday asked a state agency to determine how much could be saved if the Legislature banned insurance companies that don’t cover autism from covering erectile dysfunction.

The request was sent to Bill W. Crain, administrator of the Oklahoma State Education Employees Group Insurance Board.

“We have been told by Republicans that it is not fair for those who do not have autism to have to pay for coverage for those who do,” said Sen. Tom Adelson, D-Tulsa. “Why is it fair for those who do not suffer from erectile dysfunction to pay for those who do in the form of higher premiums? I would think most Oklahomans would rather have their premiums cover children with autism, rather than people with erectile dysfunction.”

The state does not mandate coverage for erectile dysfunction but does mandate prostrate screenings and exams, said Amber England, a spokeswoman for Senate Democrats.

“We know insurance companies cover the treatment of erectile dysfunction,” England said.

A bill to require insurance companies to cover autism died in the House and can’t be revived for two years. A similar measure did not get a hearing in the Senate.

Adelson said Senate Democrats could amend a bill to ban insurance companies from covering the treatment of erectile dysfunction if they don’t cover autism.

Sen. Jay Paul Gumm, D-Durant, said he has prepared two other amendments intended to help families of children with autism.

One would ban insurance companies that don’t provide autism coverage from receiving state incentives, such as tax credits for creating jobs, Gumm said.

Another would make the state’s health insurance “high-risk pool” cover autism, Gumm said. The high-risk pool is for those who can’t get insurance anywhere else, he said.