It appears I celebrated too
soon…back in April when OPM declared autism to be a medical condition and
decided to allow its providers to offer ABA coverage on health insurance
policies for federal employees, I was sure this would mean the major insurers
would step up to offer this important benefit. It’s been shown not to break the
bank, costing an average of 31 cents per month per insured—and that minimal
cost is passed on to the consumer anyway, so why wouldn’t insurance companies
offer it?
But only 38 plans across 23
states will offer ABA coverage. Hawaii is not one of them. And as progressive
as I’ve always thought California to be, only a portion of the state (primarily
Southern California counties) will have insurance coverage through federal
plans. In fact, in only 2 states (New Mexico and Arkansas) will coverage be
state-wide. The other 21 states will only have coverage in various regions.
So a lot of autistic kids
will either not receive the treatment they need—and deserve, or their families
will suffer a huge financial impact if they do access treatment. This inequity
never fails to disgust and infuriate me. Autism is a medical condition.
Families buy health insurance in case of medical emergencies. Autism is
definitely a medical emergency.
And ABA is a proven
effective therapy. Researchers at UCLA did a seminal study in the 1980s that
showed almost half of the children receiving intensive ABA achieved normal IQ;
most of the others improved to such a point where they needed only minimal
additional services.1
So what exactly is the
issue? I honestly cannot understand why autism is not routinely covered. Do the
people who say they “don’t want to pay for” my child’s autism through very
modest insurance premium increases not realize they will pay much more in taxes
for lifelong care?
I would make the same
argument to the legislators who tell us how they “care” about our kids, but
then vote down legislation to require insurance coverage. Are they not aware of
a study by a Harvard researcher that showed the cost of caring for an autistic
person across the lifespan to be $3.2 million—with most of these expenses
occurring in adulthood?2 The taxpayers are footing this bill.
For the small businesses
owners with more than 50 employees who fear they will go bankrupt if required
to offer plans with autism coverage, I would ask you to look at the actual data
that has been collected from the 32 states that have passed legislation. It
will not break the bank and will allow you to attract and retain the best
talent.
Even if you don’t have an
autistic child, you have a personal stake in this issue. Your tax dollars will
go for adult care for an ever-increasing population of autistic people who will
age out of the education system. Treatment while these kids are young results
in children losing their diagnoses, or needing far fewer services in adulthood.3
And beyond the fiscal issue
is the moral one—how can a wealthy country allow children who can be helped to
lead productive, independent lives just languish while there are effective
therapies available but for most, are out of reach?
1. Lovaas O.I. (1987). Behavioral treatment and normal educational
and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology
55 (1): pp. 3–9. doi:10.1037/0022-006X.55.1.3
2.
Ganz, M. L. (2007). The Lifetime Distribution of the Incremental Societal Costs
of Autism. Archive of Pediatric
Adolescent Medicine. Vol. 161, No. 4, 343 – 349.
3.
Helt, M., et al. (2008). Can Children With Autism Recover? If So, How? Neuropsychology Review (2008) Volume 18,
339 – 366. doi: 10.1007/s11065-008-9075-9.
Unfortunately, when the greatest country in the world is morally sick, it will not help it's children. Our three grandchildren are autistic and not yet in their teens. Our daughter and son in law do their best with what they have. I often tell her, being wealthy has advantages. God bless and strengthen and guide you.
ReplyDeleteThank you for your comment, Gary. I am sorry to hear about your grandchildren. I hope your children are pressing their school system to provide legally-required services for your grandchildren. It is very unfair that we expect our schools to provide therapy for a medical condition, but people are all too willing to let the insurance companies of scot-free, unfortunately.
ReplyDeleteI wish you and your grandchildren well...Janet
I mean this is ridiculous that insurance companies do injustice with them.The image you have been used is really right.Give long life and happiness to Autism child.
ReplyDeleteAutism spectrum disorder
It really is...a huge injustice. Because autism is the only cognitive disorder I know of where with proper therapy, a diagnosis can be lost. Legislators with weak spines say things like, "We really care about your children, we really, really do, but we don't believe in mandates." More like they don't want to upset the insurance companies. All sort of things have been mandated for insurance coverage, including kidney dialysis and diabetes treatment.
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