Panel backs making insurers cover autism
Print
Email
Save
Reprints
Twitter
Share
Del.icio.us
Digg
Facebook
Reddit
A House committee Wednesday approved legislation that would require insurance coverage to pay for treating autism.
A health-care insurance association decided not to oppose House Bill 958. But the standing room only crowd of family members holding photographs of autistic children scolded lobbyists for the Louisiana Association of Business and Industry and the National Federation of Independent Business, who testified against the measure.
The House Insurance Committee endorsed the measure without opposition.
If HB958 becomes law, the mandate would increase monthly health insurance premiums about $1.59 on individual policies and about $4.40 on family policies, supporters say.
Autism is a complex brain disorder that inhibits a person’s ability to communicate and develop social relationships. It is often accompanied by extreme behavioral challenges.
“It affects more children than cancer and diabetes,” said Shelley Reynolds of Baton Rouge, whose 12-year-old son is autistic. She also is an officer with Autism Speaks, an advocacy group based in Virginia suburbs of Washington, D.C.
Unlike cancer and diabetes, in which neighbors rally with casseroles and support, a diagnosis of autism often leaves the family alone to face large financial obligations, she said.
“Everybody runs away, Rey-nolds said. “They say, ‘We don’t know what to do with that and he’s jumping off the fridge.’ ”
Dr. Charlotte Hollman, a pediatric neurologist in Baton Rouge, said that in many cases two or three years of intensive treatment when the child is young could help the autistic person develop into a teenager and adult who can largely care for himself. But the treatment is intensive — lasting sometimes 40 hours a week — and costly. Insurance companies often do not cover the condition.
HB958 requires health insurance coverage of the diagnosis and treatment of autism spectrum disorders in individuals less than 17 years of age. The benefits could not exceed $36,000 per year and $144,000 per lifetime. Employers with less than 50 employees would not have to provide the coverage.
Of the 1.16 million children the U.S. Census Bureau counted in Louisiana about 1,644 children are diagnosed with autism but only about 493 would require the extensive treatment that can run more than $20,000 per year, said James N. Bouder of Hershey, Pa., who testified for the supporters.
Two weeks ago, while the full House fiercely debated legislation that would require insurance coverage for a different problem, artificial limbs, HB958’s sponsor, Rep. Franklin Foil said he was worried that his bill would be defeated. Businesses were revolting against being forced to provide insurance for so many different illnesses.
A Baton Rouge Republican who is father to an autistic child, Foil said it was willingness of the health-care insurance industry to negotiate that proved pivotal.
Gil Dupré, who is chief executive officer of Louisiana Association of Health Plans, said Foil agreed to change HB958 in ways that would provide more predictable costs for health insurers. For instance, the measure was amended to limit the total costs and to require patients show benefits from treatments that could only be provided by certified therapists.
“We really can’t support a bill that mandates coverage and increases costs,” Dupré said. “But we’re not going to actively oppose this bill.”
Bridgette Richard, director of LABI’s Health Care Task Force, testified against the bill, arguing that HB958 is yet another requirement that when added to previous mandates could drive businessmen to stop providing insurance to their employees altogether.
“You’re taking away someone else’s right to choose what they can afford. I love expensive handbags and shoes but now I’m a mother, I can’t always afford to do that, so I have to make a decision about what I can afford,” Richard said.
Members of the audience gasped and one shouted at Richard for comparing her child with an expensive handbag.
A health-care insurance association decided not to oppose House Bill 958. But the standing room only crowd of family members holding photographs of autistic children scolded lobbyists for the Louisiana Association of Business and Industry and the National Federation of Independent Business, who testified against the measure.
The House Insurance Committee endorsed the measure without opposition.
If HB958 becomes law, the mandate would increase monthly health insurance premiums about $1.59 on individual policies and about $4.40 on family policies, supporters say.
Autism is a complex brain disorder that inhibits a person’s ability to communicate and develop social relationships. It is often accompanied by extreme behavioral challenges.
“It affects more children than cancer and diabetes,” said Shelley Reynolds of Baton Rouge, whose 12-year-old son is autistic. She also is an officer with Autism Speaks, an advocacy group based in Virginia suburbs of Washington, D.C.
Unlike cancer and diabetes, in which neighbors rally with casseroles and support, a diagnosis of autism often leaves the family alone to face large financial obligations, she said.
“Everybody runs away, Rey-nolds said. “They say, ‘We don’t know what to do with that and he’s jumping off the fridge.’ ”
Dr. Charlotte Hollman, a pediatric neurologist in Baton Rouge, said that in many cases two or three years of intensive treatment when the child is young could help the autistic person develop into a teenager and adult who can largely care for himself. But the treatment is intensive — lasting sometimes 40 hours a week — and costly. Insurance companies often do not cover the condition.
HB958 requires health insurance coverage of the diagnosis and treatment of autism spectrum disorders in individuals less than 17 years of age. The benefits could not exceed $36,000 per year and $144,000 per lifetime. Employers with less than 50 employees would not have to provide the coverage.
Of the 1.16 million children the U.S. Census Bureau counted in Louisiana about 1,644 children are diagnosed with autism but only about 493 would require the extensive treatment that can run more than $20,000 per year, said James N. Bouder of Hershey, Pa., who testified for the supporters.
Two weeks ago, while the full House fiercely debated legislation that would require insurance coverage for a different problem, artificial limbs, HB958’s sponsor, Rep. Franklin Foil said he was worried that his bill would be defeated. Businesses were revolting against being forced to provide insurance for so many different illnesses.
A Baton Rouge Republican who is father to an autistic child, Foil said it was willingness of the health-care insurance industry to negotiate that proved pivotal.
Gil Dupré, who is chief executive officer of Louisiana Association of Health Plans, said Foil agreed to change HB958 in ways that would provide more predictable costs for health insurers. For instance, the measure was amended to limit the total costs and to require patients show benefits from treatments that could only be provided by certified therapists.
“We really can’t support a bill that mandates coverage and increases costs,” Dupré said. “But we’re not going to actively oppose this bill.”
Bridgette Richard, director of LABI’s Health Care Task Force, testified against the bill, arguing that HB958 is yet another requirement that when added to previous mandates could drive businessmen to stop providing insurance to their employees altogether.
“You’re taking away someone else’s right to choose what they can afford. I love expensive handbags and shoes but now I’m a mother, I can’t always afford to do that, so I have to make a decision about what I can afford,” Richard said.
Members of the audience gasped and one shouted at Richard for comparing her child with an expensive handbag.
 | ||||
| Most Popular | Most Emailed | Hot Topics | ||
