Below is a post from a mother in the Kansas City area. She posted a comment on an article from KansasCity.com
Our kids in KS & MO need this help... did you know that of the 12 common neurologic disorders (listed below), AUTISM IS THE ONLY ONE NOT COVERED BY PRIVATE INSURANCE IN KANSAS.
1. autism spectrum disorders
2. cerebral palsy
3. tourette syndrome
4. migraine
5. epilepsy
6. multiple sclerosis
7. traumatic brain injury
8. spinal cord injury
9. ALS
10. stroke
11. Alzheimer disease
12. Parkinson disease
And the more help young Autistic kids get the more functioning they are as adults - so we pay a little now & then don't have to pay a lot later! It only makes sense!
Sunday, January 10, 2010
Saturday, January 9, 2010
First Autism Treatment Center in Dallas to Provide Insurance Relief for Parents
Behavioral Innovations Works to Ensure Comprehensive Programs Available
DALLAS, Jan. 7 PRNewswire
Behavioral Innovations, the premier Dallas/Fort Worth provider of Applied Behavior Analysis (ABA) services for families of children with autism and other developmental disorders, announces its partnership with key insurance carriers to offer in-network insurance coverage for several ABA therapy programs. Behavioral Innovations is the first behavioral therapy center in the Metroplex to offer in-network insurance for select treatments - mitigating the financial burden on parents.
As of January 1, 2010, Behavioral Innovations started accepting insurance from Aetna covering payments associated with their In-home Treatment Program and SAIL After School Program. The company started accepting in-network insurance coverage from Aetna for children in their Center-Based Day Program in 2009. Starting January 11th, the company will accept United Behavioral Health, which will cover their Center-based Day Program and SAIL After School Program.
"Behavioral Innovations has proactively partnered with specific insurance companies so parents can afford necessary treatments for their autistic children," said Billy Edwards, Director of Business Development at Behavioral Innovations. "This alleviates some out-of-pocket expense and stress, which many parents face, and helps them start early intervention therapy for their child."
Behavioral Innovations is the first ABA therapy center in Texas to join Aetna's network and the first to partner with United Behavioral Health, providing in-network services. The company also provides in-network coverage for military families through Tricare/Humana, is filing claims for BCBS and Cigna and is working diligently with additional insurance companies to gain provider status and network coverage in the near future. This will allow the company to continue treating children that have developmental disorders, while making it more affordable for their parents.
"Autistic children need intensive therapy and treatment is expensive no matter how you slice it," said Edwards. "We want families to have access to comprehensive programs that best fits their needs."
Recently, the Texas legislature made it a priority to make changes in Autism insurance and treatment options. In 2007, the Texas Legislation passed House Bill 1919 to mandate that insurance companies recognize disorders on the autism spectrum. In May 2009, the legislature passed House Bill 451, widening the range of ages for insurance coverage and House Bill 192, excusing a temporary absence from school from a student diagnosed with autism spectrum disorders for an appointment with a health care practitioner.
"The Texas Legislature is helping parents overcome challenges associated with autistic children," said Lisa Martin, whose autistic daughter, Paige, attends Behavioral Innovations. "With these insurance and legislative changes, it's easier to get Paige the therapy she needs to improve her quality of life."
Behavioral Innovations provides diversified and individualized autism therapy programs in the Dallas/Fort Worth area. The qualified professionals help children who have been diagnosed with Autism, Asperger's, Cerebral Palsey, Down Syndrome, and many other developmental and behavioral disorders. Each program is tailored to meet each child's unique situation.
Behavioral Innovations offers complimentary screenings for children with behavioral or delay disorders as well as a tour of the facility for parents. Its North Texas Autism Treatment Center, located in Irving, is designed to provide a clinical setting where children receive superior therapy services.
For additional information about Behavioral Innovations and its insurance plans, contact Billy Edwards at bedwards@behavioral-innovations.com. Or to set up a complimentary admission screening email info@behavioral-innovations.com or call 469.374.0700.
About Behavioral Innovations
Established in 2000, Behavioral Innovations is the first provider in the Dallas/Fort Worth area to offer on-site ABA treatment and establish an office for consultations. The qualified professionals help children who have been diagnosed with Autism, Asperger's, Cerebral Palsy, Down Syndrome, and other developmental and behavioral disorders. Behavioral Innovations is one of the largest private employers of Board Certified Behavior Analysts in the state of Texas, with directors that hold Master's Degree in Behavior Analysis. The company is also one of the fastest growing providers of high quality behavioral services in the country. For more information, contact www.behavioral-innovations.com.
SOURCE Behavioral Innovations
RELATED LINKS
http://www.behavioral-innovations.com
article link
http://www.prnewswire.com/news-releases/first-autism-treatment-center-in-dallas-to-provide-insurance-relief-for-parents-80929637.html
DALLAS, Jan. 7 PRNewswire
Behavioral Innovations, the premier Dallas/Fort Worth provider of Applied Behavior Analysis (ABA) services for families of children with autism and other developmental disorders, announces its partnership with key insurance carriers to offer in-network insurance coverage for several ABA therapy programs. Behavioral Innovations is the first behavioral therapy center in the Metroplex to offer in-network insurance for select treatments - mitigating the financial burden on parents.
As of January 1, 2010, Behavioral Innovations started accepting insurance from Aetna covering payments associated with their In-home Treatment Program and SAIL After School Program. The company started accepting in-network insurance coverage from Aetna for children in their Center-Based Day Program in 2009. Starting January 11th, the company will accept United Behavioral Health, which will cover their Center-based Day Program and SAIL After School Program.
"Behavioral Innovations has proactively partnered with specific insurance companies so parents can afford necessary treatments for their autistic children," said Billy Edwards, Director of Business Development at Behavioral Innovations. "This alleviates some out-of-pocket expense and stress, which many parents face, and helps them start early intervention therapy for their child."
Behavioral Innovations is the first ABA therapy center in Texas to join Aetna's network and the first to partner with United Behavioral Health, providing in-network services. The company also provides in-network coverage for military families through Tricare/Humana, is filing claims for BCBS and Cigna and is working diligently with additional insurance companies to gain provider status and network coverage in the near future. This will allow the company to continue treating children that have developmental disorders, while making it more affordable for their parents.
"Autistic children need intensive therapy and treatment is expensive no matter how you slice it," said Edwards. "We want families to have access to comprehensive programs that best fits their needs."
Recently, the Texas legislature made it a priority to make changes in Autism insurance and treatment options. In 2007, the Texas Legislation passed House Bill 1919 to mandate that insurance companies recognize disorders on the autism spectrum. In May 2009, the legislature passed House Bill 451, widening the range of ages for insurance coverage and House Bill 192, excusing a temporary absence from school from a student diagnosed with autism spectrum disorders for an appointment with a health care practitioner.
"The Texas Legislature is helping parents overcome challenges associated with autistic children," said Lisa Martin, whose autistic daughter, Paige, attends Behavioral Innovations. "With these insurance and legislative changes, it's easier to get Paige the therapy she needs to improve her quality of life."
Behavioral Innovations provides diversified and individualized autism therapy programs in the Dallas/Fort Worth area. The qualified professionals help children who have been diagnosed with Autism, Asperger's, Cerebral Palsey, Down Syndrome, and many other developmental and behavioral disorders. Each program is tailored to meet each child's unique situation.
Behavioral Innovations offers complimentary screenings for children with behavioral or delay disorders as well as a tour of the facility for parents. Its North Texas Autism Treatment Center, located in Irving, is designed to provide a clinical setting where children receive superior therapy services.
For additional information about Behavioral Innovations and its insurance plans, contact Billy Edwards at bedwards@behavioral-innovations.com. Or to set up a complimentary admission screening email info@behavioral-innovations.com or call 469.374.0700.
About Behavioral Innovations
Established in 2000, Behavioral Innovations is the first provider in the Dallas/Fort Worth area to offer on-site ABA treatment and establish an office for consultations. The qualified professionals help children who have been diagnosed with Autism, Asperger's, Cerebral Palsy, Down Syndrome, and other developmental and behavioral disorders. Behavioral Innovations is one of the largest private employers of Board Certified Behavior Analysts in the state of Texas, with directors that hold Master's Degree in Behavior Analysis. The company is also one of the fastest growing providers of high quality behavioral services in the country. For more information, contact www.behavioral-innovations.com.
SOURCE Behavioral Innovations
RELATED LINKS
http://www.behavioral-innovations.com
article link
http://www.prnewswire.com/news-releases/first-autism-treatment-center-in-dallas-to-provide-insurance-relief-for-parents-80929637.html
Sunday, January 3, 2010
Autism coverage redux
Disappointment doesn't even begin to describe the dashed hopes of families who had hoped earlier this year — for the second year in a row — that Oklahoma might join several other states in mandating insurance coverage for treatment of autistic children. House Bill 1312, "Nick's Law," was defeated in a House committee.
Sen. Jay Paul Gumm, D-Durant, said of the panel's members: "They tore the Band-Aid off now quickly because they think they won't have to endure the public scrutiny for the next two years. I think that's a serious miscalculation on their part. These families aren't going away. These kids aren't going away."
To read the entire Tulsa World article, click here.
Gumm is back with two bills for the coming session. One in every 150 children struggles with autism, the fastest-growing disability in the nation. Without early, aggressive treatment, autistic children will continue to rely on parents and when those parents die, they likely will become wards of the state, a costly proposition.
Tuesday, December 29, 2009
Nick's Law proposal returns for 3rd session
by M. Scott Carter
The Journal Record December 29, 2009
OKLAHOMA CITY –
For Wayne Rohde, the third time could be a charm.
But the odds are stacked against him.Just weeks before the Oklahoma Legislature is set to reconvene, Rohde said he and state Sen. J. Paul Gumm, a Democrat from Durant, would try, once again, to pass legislation that would require insurance companies to cover patients diagnosed with autism.
Twice before the pair spent months fighting for their proposal – Nick’s Law.
Twice before they were defeated.
But this time, Rohde said, could be different.
“This will be the third straight session that Senator Gumm will introduce the legislation,” Rohde said. “We’re hopeful and optimistic that the Legislature will take a look at it.”
Under Nick’s Law, private insurance companies would be required to cover medically necessary and clinically proven medical treatments for children who have been diagnosed with autism by a licensed health care professional. Self-insured and federal employers would be exempt from the law and small business owners, he said, may choose to opt out of coverage under Nick’s Law.
The original bill, Senate Bill 1, remains in legislative purgatory in the Oklahoma Senate.
“This is very fiscally conservative health care,” Rohde said.
Rohde’s opponents say otherwise.
In May of 2008, Chris Benge, speaker of the Oklahoma House of Representatives, said he was sympathetic to the plight of parents with autistic children, but had concerns about Gumm’s legislation. Benge would later play a major role in killing Gumm’s proposal.
“The burden they carry is great, their medical costs are high and they are desperate to find hope for their children,” he wrote in a letter to Gumm. “However, it must be a priority for policymakers to evaluate public policy on a comprehensive basis. We must weigh the implications of our policy decisions as to how they will affect all Oklahomans. While it is clear that Nick’s Law would benefit families with autistic children, we must determine with certainty the impact this mandate will have on access to health care for all Oklahomans.”
Mandates such as Nick’s Law, he said, drive up insurance costs.
“There is substantial, reliable data that shows mandates do in fact drive up insurance premium costs and in turn force people to drop insurance because it is no longer affordable,” Benge wrote. “Contrary to the popularly held opinion, mandates have little effect on insurance companies because they simply pass their increased costs on to the consumer.”
Later, the Oklahoma Council of Public Affairs, a conservative think tank, distributed flyers that praised state Rep. Ron Peters, a Broken Arrow Republican lawmaker who prevented a legislative hearing on Nick’s Law.
Peters, the OCPA said, was simply defending free enterprise.
Still, Gumm and Rohde said they would continue the push for an autism mandate.
This year, in addition to Senate Bill 1, Gumm said he filed Senate Bill 1316, which would include autism coverage in the state’s high-risk insurance pool.
“If you go back and look at the history of why the high-risk pool was created, you’ll see that it was created for people who couldn’t get insurance coverage anywhere else,” he said. “If that doesn’t sound like something that is tailor-made for families like those with children suffering from autism, then I don’t know what is.”
Rohde said Nick’s Law would prevent insurance companies from shifting their insurance costs onto the backs of taxpayers.
“The companies are taking advantage of a monopoly situation and shedding the risk off on taxpayers,” he said. “By changing the law, you allow people, parents who are currently purchasing insurance, to have coverage under a health insurance plan instead of seeking out taxpayer-funded services.”
It’s the same type of law, he said, that has been adopted in several surrounding states, including Texas and Louisiana.
“
There’s a lot of opposition here,” Rohde said. “There are some in the state Legislature which say they don’t want government to tell a private industry what to do. But those same people voted for tort reform, which is telling a private industry what to do. So there’s quite a bit of hypocrisy there.”
If lawmakers don’t take advantage of the third attempt to pass Nick’s Law, he said, they will eventually pay high costs because those families will seek taxpayer-funded services.
“The long-term approach is this: If we don’t address the needs of these children at an early age, the taxpayers will be providing long-term medical care for these children – who will become adults – for the remainder of their lives.”
The Journal Record December 29, 2009
OKLAHOMA CITY –
For Wayne Rohde, the third time could be a charm.
But the odds are stacked against him.Just weeks before the Oklahoma Legislature is set to reconvene, Rohde said he and state Sen. J. Paul Gumm, a Democrat from Durant, would try, once again, to pass legislation that would require insurance companies to cover patients diagnosed with autism.
Twice before the pair spent months fighting for their proposal – Nick’s Law.
Twice before they were defeated.
But this time, Rohde said, could be different.
“This will be the third straight session that Senator Gumm will introduce the legislation,” Rohde said. “We’re hopeful and optimistic that the Legislature will take a look at it.”
Under Nick’s Law, private insurance companies would be required to cover medically necessary and clinically proven medical treatments for children who have been diagnosed with autism by a licensed health care professional. Self-insured and federal employers would be exempt from the law and small business owners, he said, may choose to opt out of coverage under Nick’s Law.
The original bill, Senate Bill 1, remains in legislative purgatory in the Oklahoma Senate.
“This is very fiscally conservative health care,” Rohde said.
Rohde’s opponents say otherwise.
In May of 2008, Chris Benge, speaker of the Oklahoma House of Representatives, said he was sympathetic to the plight of parents with autistic children, but had concerns about Gumm’s legislation. Benge would later play a major role in killing Gumm’s proposal.
“The burden they carry is great, their medical costs are high and they are desperate to find hope for their children,” he wrote in a letter to Gumm. “However, it must be a priority for policymakers to evaluate public policy on a comprehensive basis. We must weigh the implications of our policy decisions as to how they will affect all Oklahomans. While it is clear that Nick’s Law would benefit families with autistic children, we must determine with certainty the impact this mandate will have on access to health care for all Oklahomans.”
Mandates such as Nick’s Law, he said, drive up insurance costs.
“There is substantial, reliable data that shows mandates do in fact drive up insurance premium costs and in turn force people to drop insurance because it is no longer affordable,” Benge wrote. “Contrary to the popularly held opinion, mandates have little effect on insurance companies because they simply pass their increased costs on to the consumer.”
Later, the Oklahoma Council of Public Affairs, a conservative think tank, distributed flyers that praised state Rep. Ron Peters, a Broken Arrow Republican lawmaker who prevented a legislative hearing on Nick’s Law.
Peters, the OCPA said, was simply defending free enterprise.
Still, Gumm and Rohde said they would continue the push for an autism mandate.
This year, in addition to Senate Bill 1, Gumm said he filed Senate Bill 1316, which would include autism coverage in the state’s high-risk insurance pool.
“If you go back and look at the history of why the high-risk pool was created, you’ll see that it was created for people who couldn’t get insurance coverage anywhere else,” he said. “If that doesn’t sound like something that is tailor-made for families like those with children suffering from autism, then I don’t know what is.”
Rohde said Nick’s Law would prevent insurance companies from shifting their insurance costs onto the backs of taxpayers.
“The companies are taking advantage of a monopoly situation and shedding the risk off on taxpayers,” he said. “By changing the law, you allow people, parents who are currently purchasing insurance, to have coverage under a health insurance plan instead of seeking out taxpayer-funded services.”
It’s the same type of law, he said, that has been adopted in several surrounding states, including Texas and Louisiana.
“
There’s a lot of opposition here,” Rohde said. “There are some in the state Legislature which say they don’t want government to tell a private industry what to do. But those same people voted for tort reform, which is telling a private industry what to do. So there’s quite a bit of hypocrisy there.”
If lawmakers don’t take advantage of the third attempt to pass Nick’s Law, he said, they will eventually pay high costs because those families will seek taxpayer-funded services.
“The long-term approach is this: If we don’t address the needs of these children at an early age, the taxpayers will be providing long-term medical care for these children – who will become adults – for the remainder of their lives.”
Sunday, November 15, 2009
Wash DC officials propose autism insurance requirements
The Associated Press
2009-11-15
WASHINGTON -
Two D.C. Council members are planning to introduce legislation this week that would require insurance companies to improve coverage for children with autism.
Tommy Wells and Muriel Bowser plan to announce details of the legislation Monday and introduce their bill Tuesday.
If the bill passes, the District of Columbia would join a growing number of states that have passed autism insurance requirements.
Many insurers don't cover treatment for autism. Behavior therapy for an autistic child can cost up to $50,000 a year.
Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
http://www.examiner.com/a-232186~DC_officials_propose_autism_insurance_requirements.html
2009-11-15
WASHINGTON -
Two D.C. Council members are planning to introduce legislation this week that would require insurance companies to improve coverage for children with autism.
Tommy Wells and Muriel Bowser plan to announce details of the legislation Monday and introduce their bill Tuesday.
If the bill passes, the District of Columbia would join a growing number of states that have passed autism insurance requirements.
Many insurers don't cover treatment for autism. Behavior therapy for an autistic child can cost up to $50,000 a year.
Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
http://www.examiner.com/a-232186~DC_officials_propose_autism_insurance_requirements.html
Monday, November 2, 2009
OF RED HERRINGS AND PINK ELEPHANTS
Posted on OCTOBER 14, 2009:
www.urbantulsa.com/gyrobase/Content?oid=oid%3A28245
OF RED HERRINGS AND PINK ELEPHANTS
Hoping against HOPE, state GOP sit quiet on insurance coverage for autistic
children
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
housing.
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
issue.
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
classes.
Pay now or pay later.
-- Arnold Hamilton is editor of The Oklahoma Observer www.okobserver.net
www.urbantulsa.com/gyrobase/Content?oid=oid%3A28245
OF RED HERRINGS AND PINK ELEPHANTS
Hoping against HOPE, state GOP sit quiet on insurance coverage for autistic
children
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
housing.
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
issue.
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
classes.
Pay now or pay later.
-- Arnold Hamilton is editor of The Oklahoma Observer www.okobserver.net
Saturday, October 24, 2009
Nick's Law - Health insurance coverage battle continues in Legislature
Health insurance coverage battle continues in Legislature
by Jay Paul Gumm
DURANT — Hello again, everybody! Some battles at the State Capitol are over quickly; others continue, waiting on political leadership to catch up with public opinion.
The struggle to provide health insurance coverage to children with autism is one of those battles that will continue. Finding a way to help these children and their families is one of the issues to which I have devoted much effort.
For me, this struggle is a moral issue. My continued work on this is borne from my commitment to strengthen families and help ensure that every Oklahoma child has a chance to reach their God-given potential.
We are still waiting on the political leadership to catch up with public opinion. On the second night of last year’s legislative session, leaders in the House of Representatives killed the bill known as “Nick’s Law.” After that family-unfriendly vote, the leader of that committee proudly stood before the television cameras and said “Nick’s Law” was dead for two years.
Their hope was that the bill, and those families who support it, would simply go away. There have been few political miscalculations as off-base as was that one. Those of us committed to families continued the struggle throughout the session. We won a few battles in the Senate, but House leaders continued to turn their back on these families and their precious children.
Now, almost five months after the legislative session ended, those of us carrying this banner got another boost. Despite the reluctance of some legislators to acknowledge the importance of this issue, the nonpartisan Oklahoma Institute for Child Advocacy (OICA) has once again put autism insurance on its list of legislative priorities.
This group, which always has been a strong voice for Oklahoma’s children, made the decision during its fall legislative forum. At that two-day event, child advocates gathered from across the state to determine what OICA’s focus should be in 2010.
Republican and Democratic legislators addressed different panels on a host of issues. The child advocates were from every corner of the state and members of both political parties. This was as nonpartisan as you could get.
When the only question was “What is best for the children?” the answer was clear. Finding a way to help families pay for the expensive therapies necessary to give children with autism a chance at a full and happy life is – and should be – a top legislative priority for our state, regardless of partisan political considerations.
This is an issue both political parties have embraced in other states; in some states, the charge was led by Republicans. Oklahoma children deserve that same bipartisan support, and I will continue working to that end.
As always, if you have comments, questions or concerns about state government, send me a message through my website at www.gumm.us. You can also follow me on Facebook at www.facebook.com/jpgumm and on Twitter at twitter.com/jpgumm.
Thanks again for reading the “Senate Minute.” Have a great week, and may God bless you all.
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