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Posted on Tue, Nov 23, 2010 : 4:29 p.m.

Senate must act now: Reform Michigan's insurance laws to cover autism

By Guest Column

The Michigan Senate may consider legislation next week that would enable thousands of Michigan families to access the care they need, and would save our state millions every year. The House passed this legislation by an overwhelming bipartisan vote last year.

Reforming our state's insurance laws to include autism is not only the right thing to do for Michigan's children and families; it makes the most sense for our state's economic future, saving billions of taxpayers' dollars.

Autism affects one in 110 children, and one in 70 boys. When I began serving in the Legislature five years ago, approximately 10,000 children in Michigan had autism. Today, the Michigan Department of Education estimates that autism affects more than 15,000 children.

Despite this rapid increase, insurers continue to deny coverage to children with autism. Michigan insurers cover a wide array of other prevalent disorders and diseases, including cancer, epilepsy, and diabetes, but continue to deny coverage to the thousands of children and families affected by autism. These families should have the same access to proven medical treatments as those families affected by diagnoses already covered.

This discrimination costs our state much more in the long run. A 2009 study calculates a total savings of $13.9 billion if Michigan changes our laws to cover the diagnosis and treatment of autism.

Ensuring autism treatment services will bring jobs to Michigan. The Behavioral Analyst Certification Board reports that Michigan currently employs only 83 board certified behavioral analysts. Florida enacted reforms to ensure coverage in 2008, and now has about 1,800 certified behavioral analysts.

In addition, autism coverage will benefit our schools and communities. Every year, Michigan public schools spend more than $100 million to accommodate students with autism. With diagnosis, early intervention, and treatment, special education classes will shrink.

Early intervention allows more children to function independently as they reach adulthood, which would save the state an average of $2 million over the life of each child with autism. This will allow many to secure employment and live independently as adults instead of relying on state and federal programs like job training, Medicaid, and adult day care.

To date, 23 states have passed autism coverage reform legislation. Leaders across the country are recognizing and correcting the injustice of denying coverage to children and families affected by autism.

Michigan's budget deficit for the coming year is projected to be $1.6 billion. Our state cannot afford to allow another year to go by without making this important change. I urge our 37 sitting state senators to support autism coverage reform legislation and ensure that Michigan families and children can access the treatment they need.

State Rep. Kathy Angerer, D-Dundee, is the majority floor leader in the Michigan House of Representatives. She represents the 55th District, which covers parts of Washtenaw and Monroe counties. You may contact her office at (888) 345-2849.

Comments

Jon Saalberg

Fri, Dec 3, 2010 : 6:12 p.m.

This is victory for the GOP, the insurance industry and those who make money on health care. The losers are children and families in Michigan, who would greatly benefit by having guaranteed coverage for their children. It has been clearly shown that the costs of covering children with autism, and children on the autism spectrum, far out weigh guaranteed coverage costs. It's sad that we live in a state in which the truth is that their we have fellow Michiganders who think their fellow residents do not deserve necessary health care services.

stunhsif

Fri, Nov 26, 2010 : 8:53 p.m.

Ms. Angerer said: "Autism affects one in 110 children, and one in 70 boys. When I began serving in the Legislature five years ago, approximately 10,000 children in Michigan had autism. Today, the Michigan Department of Education estimates that autism affects more than 15,000 children." Regarding your numbers above what age range are you talking about? Secondly, there is so much "gray area" as to what autismn actually is, it is not a "black or white" disease and many question whether it is a disease or not. But regardless, if you force insurance companies to cover this, then the number of children "diagnosed" will quintuple and the only way insurance companies can cover the extreme cost increases is to raise the price of insurance for everyone else. Not the right thing to do in my opinion. Good Day No Luck Needed

robyn

Wed, Nov 24, 2010 : 11:28 p.m.

@ TopCat: It can be any number of things. In my daughter's case it's an inherited condition. It can run in families. There is an entire school of thought that tie autism to childhood immunizations. Thre has been research both supporting this and not supporting it. However - you have to look at who funded the research to begin with. I really don't think it's so much more prevailent now as opposed to the past, it just wasn't diagnosed before unless the autism was fairly profound. It's more difficult to diagnose in girls when they are young because many of the behaviors are associated with 'girlish' behavior (refusal to talk, a bit obsessive about certain things, shyness - stuff like that). I know one of the most difficult things for me upon learning that my daughter had Asperger Syndrome (she was obviously different) was that many kids that had remained undiagnosed - they were on the spectrum and functioning - but not 'normal', with learning disabilities and social difficulties - had higher suicide rates than the average teenager. A child can be on the spectrum (very high functioning) and still have difficulty socializing and in school. Undiagnosed it can lead to some real mental problems. These kids are not like other kids - and that's not bad - but they also have a very hard time 'fitting in' (if they ever do at all) and they can be an easy target for bullies because they're different. Some are oblivious to it all, others are very 'inward' looking and don't understand it. There's a goor web site - it's called "Wrong Planet" - the forums are excellent. You can learn a lot there.

Top Cat

Wed, Nov 24, 2010 : 1:14 p.m.

I'm no expert on the cause of autism but if the rate is rising so quickly it would appear to be be related to some recent phenomenon. I'm reading more that is may be linked to a vitamin D deficiency due to young children spending more time inside and the excess use of sunscreen. Any thoughts?

timeatwork

Wed, Nov 24, 2010 : 10:58 a.m.

i am shocked to find that it isn't covered!

ypsiarbormom

Wed, Nov 24, 2010 : 10:03 a.m.

@LAEL...you are right. English and grammar class were never a strong point for me. Bottom line on insurance reform for autism is that it is the right thing to do and saves tax payer money in the long run.

LAEL

Wed, Nov 24, 2010 : 9:18 a.m.

@ypsiarbormom I think you had the wording right the first time. Read your "typo" fix again.

ypsiarbormom

Wed, Nov 24, 2010 : 9 a.m.

typo...sorry.... Without the proper early intervention and coverage of therapies, their chance of being independent job holding adults instead of wards of the state greatly INCREASES.

ypsiarbormom

Wed, Nov 24, 2010 : 8:55 a.m.

It's not only the right thing to do, it is matter of efficient economic forecasting. I have two children with autism. I would like them to be future tax payers and not future tax burdens. Without the proper early intervention and coverage of therapies, their chance of being independent job holding adults instead of wards of the state greatly decreases. With the lifelong costs of caring for a dependent autistic adult, intervening now with insurance reform is a tax payer savings over time. Right now in the state of Michigan if your child gets hit by a car and needs speech, physical or occupational therapy, it is covered. If your child is hit by autism, needed therapies are not covered. My children are being discriminated against by the insurance companies. Not only should they receive coverage because morally its the right thing to do, but it is economically more sound for the tax payers of Michigan in the long run.

Macabre Sunset

Wed, Nov 24, 2010 : 1:17 a.m.

If the insurance increase is $1 per month per child, and 1 in 110 children have this disease, then the cost per family for treatment is less than $100 per month. So I'm not seeing the financial crisis that treatment brings. Especially for the poor who do have access to state programs. So I suspect that quoted figure is deceptive. As was Obama when he said Obamacare would save money. Not even a year later, and that's proven to be one of the bigger whoppers ever told by a president. If health care reform is possible, I'm all for it. But the way we do things now, using insurance companies and employers as middlemen and refusing to reform the way health care is provided in America, is a recipe for financial disaster.

babmay11

Tue, Nov 23, 2010 : 10:56 p.m.

Autism is specifically excluded from nearly all insurance coverage, even though there are efficacious treatments supported by research. The insurance companies just don't want to pay for it. But in the long run the costs are much higher when you do not do intensive early intervention, many individuals with autism can become much more independent, even to the point where they don't need any type of support. This will save taxpayers millions in the long run, and there are some pretty well costed out studies confirming the savings. Mental health coverage usually does not include autism. 23 other states have already passed this kind of legislation, and there have not been big increases in costs, less than $1 a month in most cases. Insurance companies have refused to provide very specific data, which means the numbers do not back up the assumption that costs go up significantly. This is a type of discrimination that needs to be rectified, and the added benefit is saving money too. I have two boys on the autism spectrum and I cannot imagine where they would be without the ABA therapy we have done over the years. Hopefully they will both be able to hold jobs and be taxpayers instead of having to rely on lifelong assistance. That is what we are asking for, just a chance for our kids to be able to reach their potential.

jcj

Tue, Nov 23, 2010 : 9:50 p.m.

I support legislation that would include autism coverage. But like most of us do when lobbying for a cause, State Rep. Kathy Angerer is making some pretty wild assumptions on what will actually be saved. How often are we told how much something will save us only to find out later only a fraction of what what was claimed is saved? Or worse it cost more! None the less I would support this legislation.

robyn

Tue, Nov 23, 2010 : 9:05 p.m.

We don't need social medicine. Parents that do not have insurance or the financial means to pay - can get help through state funded programs. It's those of us that can afford insurance - and earn too much to qualify for state funding - but not enough to pay for it ourselves - that are stuck. And thus, our children can be stuck. I have good insurance - it even pays for a portion of 'mental health care' - which is what autism falls under. Unfortunately it's just not that simple because autism is there all of the time - it's not a chemical imblance that can be treated with medication - and followed up on every so often to make sure the pills are working. These kids need a very different kind of treatment and therapy. They don't go to the shrink and talk about their problems.... If we pay for insurance - we should be covered.

johnnya2

Tue, Nov 23, 2010 : 8:35 p.m.

Raising rate son everyone is just fine. That is what insurance is for. If you only insure healthy people it is throwing money at insurance companies. I don;t see how autism would not be part of the health care act and its pre-existing conditions proviso. I am 100% behind SINGLE PAYER UNIVERSAL COVERAGE. I do not mean a Canadian privatized system, but more like what we give our veterans. Pure socialized medicine!

robyn

Tue, Nov 23, 2010 : 8:24 p.m.

And when the insurance companies decided to pay for Viagra we paid for that too. As a parent of a child with Asperger Syndrome - I can tell you that - even with some covered costs (under 'mental' health) - diagnosis and treatment is expensive. The younger a child is when they begin therapy - the better off they will be later. Depending upon where a child is on the spectrum - there is no reason to believe that - with proper treatment - these kids can't live normal productive lives. My daughter was diagnosed at the age of 3 - at that point things didn't look real great as far as her future. I can relate to the parents that have children that will always need supervision and will never function independently - that what we were looking for our daughter. We were able to find good therapy and our school system was terrific. (It still is.) She's now 14, an honor roll student, orchestra/violin, played volleyball and takes all of the same classes and does all of the same work as is expected of any other child. Most of her teachers don't even realize she has a spectrum disorder now. While she is a 'different' kind of kid as compared to her peers - she actually has friends and has learned to participate. She has already chosen which college she plans to go to - and I have no doubt she will go. This is what we have now. But we could afford the additional cost of getting her the support and therapy she needed to BECOME what she is. There are so many parents that can't afford it - and they have insurance that won't cover it. If you choose to think of this in the terms of how it will affect you financially - how much do you think it costs to keep a person in an adult care facility with aides that can supervise them? A person with that type of status can not work a job that can pay for all of their needs - therefore the taxpayers will foot the bill once the child becomes an 'adult' - if the parents can't afford to pay for their care. Now - think about the initial cost of working with a child and that therapy/treatment means that they will eventually be able to live independently - if not excell and do quite well? Instead of being a tax drain, they have become a tax payer. My interest in my child and her future are personal - you don't know her - therefore it's hard for you to imagine what it has been like to raise her thus far. Thankfully - everything seems to be normal and the outlook is nothing but good if she continues to excel. But - I can alo understand the financial aspect, and in the long run - the intital cost of treatment lowers the long term care costs that would be incurred if left untreated.

David Briegel

Tue, Nov 23, 2010 : 6:46 p.m.

Oh, but "we have the best health care system in the world"! Except when you need it. Except when we don't. Another American Myth! And We Don't Need Single Payer!? HA! And we will defend huge advertising, promotion, bureaucracy, bonuses and profits over health care forever! Just like the corporatocracy wants us to believe.

josber

Tue, Nov 23, 2010 : 6:19 p.m.

The estimated costs for autism insurance coverage is a few dollars a month. However, not treated properly, as is occurring now, still results in increasing costs. Those afflicted are recieving many more services as they never got the right service in a timely manner. Trust me, right now Michigan is catching the costs on the back end, and they are much higher than they should be. The estimated rate of autism is soon to be 1 in 57 boys. The numbers keep going up alarmingly.

Macabre Sunset

Tue, Nov 23, 2010 : 4:59 p.m.

Of course, you understand that if you force insurance carriers to cover autism, they will raise their rates for everyone. This, in turn, will raise employer costs, which means less jobs and increased co-pays for those with job-provided insurance and increased costs for those who purchase their own insurance. Nothing is free in life. You want this coverage, you have to purchase it.