Saturday, February 28, 2009
HB 1588: Autism Spectrum Disorder; Mandated Health Insurance Coverage
What is HB 1588?
-Requires private health insurance companies to supply coverage for those diagnosed with autism spectrum disorder
-Coverage is provided only for those under the age of 21
-Maximum coverage of $36,000 per year
-Insurers cannot terminate or refuse to renew coverage because the individual is diagnosed with, or has received treatment for one of the autism spectrum disorders
-This bill, if passed, would take effect on January 1, 2010
Sponsors: Marshall, R.G., Amundson, Barlow, Bouchard, Bowling, Bulova, Caputo, Carrico, Dance, Englin, Hall, Hugo, Hull, Knight, Lingamfelter, Loupassi, Marsden, Mathieson, Miller, J.H., Miller, P.J., Nichols, O'Bannon, Oder, Poisson, Rust, Spruill, Valentine, Vanderhye and Ware, O
What do you need to know about Autism Spectrum Disorder?
Autism spectrum disorder includes:
1) Autistic Disorder
2) Asperger's Syndrome
3) Rett syndrome
4) Childhood Disintegrative Disorder
5) Pervasive Developmental Disorder - Not Otherwise Specified
Symptoms of Autism Spectrum Disorder include:
1) Communication- problems developing communications skills, both verbal and non verbal
2) Social- examples include understanding how other think and feel, and sharing emotions
3) Routine or repetitive behaviors- examples include repeating words and/or actions, obsessive behavior, and playing in repetitive ways
Treatment for autism spectrum disorder includes:
1) Habilitative or rehabilitative care
2) Pharmacy care
3) Psychiatric care
4) Psychological care
5) Therapeutic care
So, why should we support HB 1588?
According to an article from the Harvard School of Public Health, the total cost of care for an autistic individual can be up to 3.5 million dollars over his or her lifetime.
Care can include: speech therapy, physical therapy, behavioral therapy, family training, nutritional therapies, occupational therapy, sensory integration therapy, relationship development therapy, respite care
Autism is a medical problem which requires enormous expense; it is not feasible or possible for families to pay out of pocket. Children who do not get good care and treatment early in life are more likely to become independent contributors to society as they age. The less care they get as children, the more care they will need later in life, often requiring these individuals to receive full care in government funded facilities. The approval of this bill will save the government money because it will cost them more than $36,000 a year to provide full care to autistic adults that did not receive proper care as children.
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My older sister's nephew has Autism. I have spent a great deal of time with him and his family and I have personally seen the impact it has on the family. There needs to be a lot of love and support to care for a child like this. In order to try to get the best care for the child they have him enrolled in special after school programs, as well as a lot of one on one work at home. Lots of doctors appointments, therapy, etc.
ReplyDeleteI think it is great that there is bill out there to help with all of the costs of health care that can come up.
I agree with SMC, I think it's extremely important for there to be a bill out there to help will the extra costs of health care because as a nursing student msyelf, I have seen how the problem can worsen with time due to lack of money or resources.
ReplyDeleteQuestion-the bill requires private insurance companies to supply coverage, well would there be any stipulation for the families when they went to get insurance? For instance, would it cost them more to buy insurance in the first place if they already had a child with Autism?
I think this bill is a great idea and I hope it is supported because this is truly a population in need of support.
I think that the government taking the initiative to create a bill that supports such a noble cause a great start, as well as a step in the right direction with preventative medicine. I have seen lots of coverage on people advocating for more spending and more attention to this disorder (they had a campaign on VH1 Classic on Autism speaks) and I am very excited about it. I am mostly glad that this bill would provide preventative care for the progression of the disease.
ReplyDeleteOne of my concerns with the bill is that the coverage only lasts till the individual is 21, which poses a problem. What happens when the person reaches that age? Will they be thrown to the street? Or will the government provide services to care for them once they hit that age? I realize that covering someone for that long can really drain money, but it is something to think about.
I agree that the government should start cracking down on insurance company. This is a very serious issue and a lot of people suffer from this daily. I believe this is more than enough for the insurance company to start covering this care in their policies. I also believe government should also put money aside for those families who do not have insurance coverage so they can still receive care. I support this!
ReplyDeleteThis bill would really help those families providing for a child with autism. I can't believe that the total cost of care for an autistic child was $3.5 million! I'm sure many of the families are not able to work full time while caring for their child, so this bill would greatly benefit them in affording the necessary care.
ReplyDeleteI support this bill entirely, most people do not know the cost of having a child with Autism. This bill would help families provide the care that these children need.
ReplyDeleteI have a friend with an older brother who has autism, it has been a financial struggle to care for him since he was diagnosed with Autism. With speech therapy, physical therapy, and special schooling, it is an increasing financial stressor; if this bill was passed earlier, I'm sure it wouldn't have been as much of a struggle for them. I agree with Deanna about her concerns that the bill only covers the child until they are 21. In reference to my friend's family, her brother is in a group home with other autistic men and women. Her parents pay out of pocket for him to live there and still pay for his finances such as food, cost of living, clothes, and his educational and therapeutic needs. The government is wiling to pay for the child until they are 21 but then what?
I really like that these politicians have chosen to sponsor this bill. It really goes to show that there still are some good people left in politics. The bill states that it will require "private" health insurance companies to cover Autism Spectrum Disorders, what about public insurance companies like Medicaid or FAMIS? If you are interested here is a link that will take you to a website that donates $0.49 every time you visit the site. http://www.whatkindofworlddoyouwant.com/videos/view/id/408214
ReplyDeleteIn response to Courtney:
ReplyDeleteBelow is an excerpt from Connection Newspapers, explaining that the monthly premium costs for insurance in Louisiana and Pennsylvania would increase for all insured families, not just those with autistic children, to give treatment to these children.
"H.B. 1588 is similar to laws enacted in Louisiana and Pennsylvania, two of the eight states that have enacted legislation ensuring coverage of children with autism. The Louisiana Legislative Fiscal Office estimated the total premium cost of autism coverage in that state as ranging from $1.12 to $3.87 per policy per month, while an independent panel report in Pennsylvania found a marginal premium increase cost of approximately $1 per insurance plan member per month attributable to the autism benefit. H.B. 1588 will likewise have a similarly modest impact on premiums."
In response to Deanna Manuel:
HB 1588 states, “each health maintenance organization providing a health care plan for health care services shall provide coverage for the diagnosis and treatment of autism spectrum disorder in individuals under the age of 21”. We agree that it is a problem that after the age of 21 these autistic children will no longer be covered but this is partly because after the age of 21 most private insurances don’t cover children any longer. At this point, they are responsible for acquiring their own insurance. For Autistic people over the age of 21 who have developed the skills to maintain some type of job will then be responsible for getting their own insurance, which may include Medicaid or other government funds that help subsidize the cost of housing and health care for disabled peoples. For autistic people over the age of 21 who are not high enough functioning to care for themselves or work there are both private (very expensive) and public (government subsidized) institutions where they can live and be cared for, including medical care.
Even though the government no longer provides financial support for Autism patients over 21, they aren’t left alone. There are great non-profit organizations such as Easter Seals (www.easterseals.com) that are geared specifically towards helping people with Autism who are 21 and older. This organization works specifically helping Autistic adults with financial planning, learning technical and communication skills to help secure jobs, and social and residential integration. This organization offers support, education and therapy to help Autistic adults continue living successful lives. Their services are free and are readily available to help Autistic adults.
In response to Jill:
HB 1588 does not cover families utilizing public insurance. These public insurances are already covering certain therapies and treatments for autistic children.
I think this is a great bill. The cost of caring for a child with autism is astronomical! Caring for children with autism can be difficult emotionally and financial worry just adds to the burden. Although it does only cover them until they are 21 think of all the money they could save during that time. Also, I see that they mentioned that there are non-profit organizations that will help the families out.
ReplyDelete