Legislator questions bill on autism coverage / LJWorld.com

Kansas Legislature

February 22, 2009

Topeka — Legislation that would require insurance companies to cover the treatment of autism appears to be on the ropes.

State Sen. Ruth Teichman, R-Stafford, who chairs the committee considering the legislation, issued a news release raising several questions about Senate Bill 12 and voicing concerns that the measure would increase insurance premiums.

“Unfortunately, the current economic situation in which the state and local government find themselves does not lend itself to increasing the costs of health insurance policies paid for by tax-supported entities,” said Teichman, who chairs the Senate Financial Institutions and Insurance Committee.

“The private sector is also suffering during this recession, and committee members are concerned about adding additional financial burdens to employers and their employees,” she added.

But Mike Wasmer, Olathe, of the Kansas Coalition for Autism Legislation, said Teichman’s comments are “a little maddening.”

The issues Teichman has raised have been addressed, he said.

For example, Wasmer said, Teichman said there is conflicting testimony that expanding autism coverage would raise premiums anywhere from 1 percent to 7 percent. But Wasmer said actuarial reports provided by his organization, including a third-party report, say the increase will be less than 1 percent.

The legislation would require insurance companies to cover the diagnostic evaluation and treatment for autism disorders.

Insurance companies and business groups oppose the bill, saying the increased cost of insurance may result in some employers dropping insurance coverage for their employees.

But Wasmer, whose 9-year-old daughter received a diagnosis of autism, said providing insurance coverage will result in more early diagnosis and treatment, which will save money in the long run.

Discussion

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22 February 2009
at 2:20 a.m.

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angelgabriel (Anonymous) says…

Simply put, the fact that insurance companies do not cover medically necessary treatments for autism that have been proven through scientific evidence is healthcare discrimination that needs immediate attention in the state of Kansas! The actuary study is out, and the numbers are running less than one percent of an increase in premiums. Some “companies dropping their insurance for employees” because of this is absurd! By providing these individuals with medically proven treatments such as applied behavior analysis, this bill can significantly save the taxpayers of Kansas, take the burden of educating those with autism off the schools, and stop the injustice these Kansas families are facing that can tear them apart. The CDC is calling autism a national public health crisis. Without medically necessary treatment, when these individuals age out, we are going to see a tremendous burden on a system that already is being ignored, neglected, and is invisible to those who do not live it day in and day out.
22 February 2009
at 11:01 a.m.

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KsTwister (Anonymous) says…

Insurance companies are the second biggest glut to the American economy, they may not have CEO's but they are not about to help with any more than they absolutely must. Even then it will just be a 'token' of what should be offered. Now here is an industry that really should be examined closely. Rates raised so high that some employers are not only cutting benefits but dropping it altogether. When was the last time you heard about a struggling insurance company…………never.
22 February 2009
at 12:22 p.m.

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jayhawki (James Bart) says…

Is she opposed to providing coverage to some of the most “hidden” members of our community or do her alliances belong to the insurance industry? I plan to contact her office on Monday and see if this is her true concern (cost) or if she is ingorant of the concerns of Kansans who have been wrongfully excluded from coverage for the lame reason “Autism is not a medical condition.”

Fair is fair and facts are facts-these are not needs that should be ignored for the sake of insurance company profits. There is no valid reason why these children (and their families and the community) should suffer because the coverage they paid for is being wrongfully denied. Kansas should adopt this version of “Kates' law” that reasonably provides coverage.
22 February 2009
at 10:13 p.m.

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CommonMom (Anonymous) says…

part one:
I’m sorry, Senator Teichman, but “the current economic situation” has nothing to do with the need for kate’s law. As far as the Kansas Insurance Monopoly is concerned — it has not been, nor will it ever be, the “RIGHT” time to cover the neurological disability known as autism. For Kansas Children, Kansas Families, Kansas Schools, and the State of Kansas — it is a necessary time to demand an end to health care discrimination against families challenged by a loved one’s diagnosis of autism.

The entire focus of kates law is to UPDATE health care policy in Kansas. It is to allow access to a funding stream that taxpayers are already paying for with their monthly insurance premiums; a stream, which to date, has denied coverage for the diagnostic evaluation AND services related to autism. This is about social justice. This is about a neurological disability that is discriminated against by every health care insurance agency in the state.

Approximately 50 children are diagnosed monthly in the greater Kansas City Metro area alone. The diagnosis of autism has become more prevalent than that of juvenile diabetes, childhood leukemia and AIDS combined. Would our legislators allow health care discrimination against families struggling with any of these disorders?

Senator Teichman states, “The private sector is suffering”. Families with autism are a part of the private sector as well. They are citizens, employers, employees, and taxpayers. They are also suffering — not just from the faltering economy as are other citizens, but also from being injured by medical insurance discrimination.

Data collected from states which have mandated autism health care coverage (8 states have already adopted it and 25 are working to secure it this year) indicates a less than 1% increase in premiums – or approximately $48.00 a year/family. Kansas families with autism are currently paying $30,000-$120,000/year to provide medically recommended intervention services. This does not include the countless hours of valuable employee productivity lost or squandered due to time off from work while resolving crises related to the caring for a loved one with autism. This committee is thinking “Pennywise and Poundstupid”. Dumping this healthcare crisis into the future would be a misjudgment for the state of Kansas, both today and tomorrow. The objections raised by the insurance industry’s lobbyists were shameful, embarrassing (even for them), and devoid of any
documentation to support their claims. The insurance industry probably has more money than the US government at this point. The insurance industry claims that autism is an education problem. Well, I’m sure the State Board of Education and the Department of Education will be quite surprised to hear that (false) claim.
(see part two)
22 February 2009
at 10:15 p.m.

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CommonMom (Anonymous) says…

part two:
The Kansas Autism Task Force appointed by the Governor recommended that updating the state’s health care policy to include autism was a priority. The efforts of the Kansas Coalition For Autism Legislation (KCAL) has performed exhaustive research regarding the nationwide efforts that have taken place in other states to address this public health crisis. In partnership with Autism Speaks, and with support from the Autism Society of America and Kansas state autism organizations, KCAL has developed a plan that “SAVES
children, saves families, saves schools and saves kansas”.

Senator Teichman and her committee can continue to “sit on the rope” all they want. They
can continue to “rope-a-dope” — lean against the ropes trying to tire and wear-out the autism advocates, but this tactic will never succeed. They can “bob and weave” around the facts, data and logic repeatedly presented by medical health professionals and continue to attempt to ignore the truth. They can continue to “take-a-dive” when confronted by the health care industry’s scare tactics, to avoid angering the industry in any way. OR, they act like responsible adults and elected officials — and make a stand.

The question is so simple, so raw, so real — Will Kansas allow the health insurance industry to continue to discriminate against children with autism? YES or NO? Will this committee allow Kansas’ social service agencies like Infant and Toddler Services, Social and Rehabilitative Services and the Department of Education to bear the brunt of a neurological disorder? Would they be acting in the same fashion if it were cerebral palsy, epilepsy or meningitis? I don’t think so, but in this “current economic situation”, some of our state’s citizens are already receiving a “knock out“ punch. The only ones in the crowd that are cheering are the insurance industry executives. They’ll be laughing in their limos, on the way to their corporate jets, for travel to their vacation homes in another state.

kate's law is not about a bail out or a hand out. It is about upholding the law that is designed to require medical insurance companies to cover the expenses involved with legitimate medical diagnoses and treatment. Senator Teichman's committee is accountable to WORK this bill NOW — and get it to the Senate Floor immediately.

[For the honest truth about this public health crisis of national importance, try visiting www.autismvotes.org., autismsocietyofamerica.com, or www.ks.coalitionforautismlegislation….
23 February 2009
at 10:22 a.m.

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CommonMom (Anonymous) says…

Correction…the websites to visit to get the real truth about this public health crisis are
www.autismvotes.org
www.autism-society.org
www.kscoalitionforautism.org
23 February 2009
at 1:47 p.m.

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keebler1rk (Anonymous) says…

Listen up legislators. you can pay me now, or you can pay me later! Autism must be diagnosed & treated as soon as possible. Wake up America, A little money spent now will save untold amounts in the future. As the parent of an autistic son I can truely say early intervention has done amazing things for my son. I can also say he has a chance to become a productive member of society. Without treatment he would be a burden on society for the rest of his life. There should be no debate. Do the right thing!

24 February 2009
at 12:56 p.m.

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geekyhost (Anonymous) says…

You can either pay for proven treatments now, or you can pay for group homes and lifelong care later. Fiscal responsibility does NOT mean sticking taxpayers with a giant bill later on. Or does it? Since you're not likely to actually fund the autism waiver this year, nor increase funding for SpEd in schools, this is the least you could do.
24 February 2009
at 1:54 p.m.

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queenbee04 (Anonymous) says…

I don't have a child with Autism…but NOT being in favor of the law, seems like the ultimate discrimination. Let's see…my insurance will cover my treatments for my child with asthma, but if my child has Autism….I'm out of luck! That makes sense Senator???
24 February 2009
at 1:56 p.m.

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Lefty1974 (Anonymous) says…

I was at the hearing in Topeka and it is amazing to me that somewhere, and who knows where, Senator Teichman concocted a range of 1%-7% as an increase in costs. I don't ever remember hearing anyone, including the lobbyist's for the healthcare companies, mention a number greater than 1%. Both lobbyist who spoke gave a very vague and uneducated prediction that did not include any dollar amounts. On top of that one of them for some crazy reason decided to make the comment that his healthcare company has already been paying thousands of dollars of claims related towards Autism. Funny, if that was the case I don't think there would have been a need for any of us to waste the time of Senator Teichman and the other senators.
I am one of the very few in the state of Kansas whose health insurance pays for my childs treatment, and that is only due in part to my employer being based in MN. I have had numerous conversations with the Director of Behavioral Health for my healthcare company in regards to what their claims show as an increase in overall costs since mandating Autism coverage. Are you ready for this…based on their overall membership (which is much larger than the state of KS) and the actual number of services being paid for Autism treatment (way more than KS has to worry about), their overall increase in premium is below .05%. That is below 1% not 5%.
For anyone in the KS Senate that would like to discuss this with my contact at my healthcare company, please let me know. They would be more than willing to provide this same information to you as well.
With all of the cuts being made to our schools, does it really make sense to keep all of the burden on them to treat our children? Or should the healthcare companies, who seem to be making a pretty fair dollar these days, sharpen their actuarial pencils just a little bit? Until they are able to provide an accurate (better yet, realistic) picture of the true dollars at stake, our Senate will continue to be misinformed.
Do the right thing Kansas! Act now, or these little dollars we are talking about today are not going to be so little a couple of years down the road.
24 February 2009
at 2:34 p.m.

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HodgePodge (Erin Parmelee) says…

KsTwister (Anonymous) says…

Insurance companies are the second biggest glut to the American economy, they may not have CEO's but they are not about to help with any more than they absolutely must. Even then it will just be a 'token' of what should be offered. Now here is an industry that really should be examined closely. Rates raised so high that some employers are not only cutting benefits but dropping it altogether. When was the last time you heard about a struggling insurance company…………never.
––––––––––––––––––––––-

Um, I work for a “struggling insurance company” so of course they exist. I think comments like the one above spring from not knowing much about how the insurance industry works. You're not purchasing a coverage package for anything and everything that could and might ever happen to you (and people would know that if they read the insurance contract)—you're spreading the risks around. That's all. Insurance companies aren't evil—people just fail to understand how they work. In my experience anyway. Ever wonder why insurance rates go up? Blame lawsuits like the ones that will stem from this issue.
24 February 2009
at 2:49 p.m.

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jafs (Anonymous) says…

We're also all paying for the uninsured who use the ER for their health care.

And, insurance companies have a built-in incentive to make a profit, which often translates into denying coverage.

Health care is not a commodity like potato chips, and we really should figure out a better way to deliver it.
24 February 2009
at 6:25 p.m.

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dogooder (Anonymous) says…

Since the economy is so bad why don't we just let insurance companies decide what they will and won't cover. I'm sure they will be fair! They only have our best interests at heart.
Seriously, WHY are we even listening to what these lobbyists have to say? The insurance companies wouldn't cover diabetes and open heart surgery if they thought they could get away with it. They are in business to make money! They take money for your coverage then they try to avoid paying for your care. That's how they do it.
Autism is a medical condition. Simple as that. Just like kids with epilepsy, diabetes, cancer, asthma…these families need and deserve medical care. Early intervention will more than pay for itself!
It's too bad we have to have laws to force people in power to do the right thing. It's too bad one of the big insurance execs can't say, “WE are going to do it because it's the right thing to do”. Then I suspect the others would follow suit. If you are one of those people who could make a difference by doing the right thing, I hope you do it.
25 February 2009
at 12:29 p.m.

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gbs79 (Anonymous) says…

HodgePodge, It's always interesting to hear what people who work in the health insurance industry have to say about autism treatment coverage, so thank you for your post. You implied that lawsuits would become a factor in future health insurance premium increases. What lawsuits do you see arising from this issue? Which entities do you think would file such lawsuits, against whom and for what reasons?
26 February 2009
at 10:33 a.m.

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KatWrangler (Anonymous) says…

keebler1rk

I agree with you! Its sickening how cheap the GOP is acting. They are so out of touch at what is going on out here. They have no clue and its sad. Sad for us because we bear the brunt of what they do.

FTR - I am a Dem.

26 February 2009
at 11 a.m.

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tolawdjk (Anonymous) says…

As a parent of a child with autism, I can vouch for early intervention. My son was diagnosed at 20 months and while my insurance doesn't cover ABA, what it does cover has help immensely. The turnaround from where he was at diagnosis and where he is today is staggering.

That said, I am still paying out of pocket for the portions of the year that it won't cover…20 visits don't go far. thankfully, I have an income that allows for this. I don't have to anguish over putting food in his stomach vs. bettering his abilty to adapt to his condition. Additionally, while his therapist isn't quote ABA unquote certified, she is using the approach and outline recommended by that treatment.

My family is lucky. We drew a short straw and we have made the best of it. The development of your child should not depend on luck.

I'm not saying that it should be a mandated coverage event. What I would like to see is the option to add it. Many providers have “high” and “low” cost options. Insurance should be required to offer a high and low, and this type of treatment should be standard within the high option. Consumers should be allowed to enter into a plan without being shot down with autism as a “pre-existing” condition. Consumers should have a fair choice and a standard level of what should be expected by a provider.