Ron Black: Autism Insurance Coverage DOA

We kind of knew that this would not be the year to see autism coverage mandated, nor really is there a chance next legislative session.

Opinion By Ron Black

But the rally for health care reform proved that once again, it's all about the money - all about cash flow rather than human life.

It is ironic that the Chambers of Commerce and Pam Peterson are going at it over the issue of human life, but children with autism don't mean much to the pro-lifers I suppose. Heck, I am seriously pro-life but the irony of how folks are up at arms over stem cell research on embryos but couldn't give a rats ass about kids with disabilities such as autism is staggering.

We members of the pro-life community love the little babies, we love them as they are in their mother's wombs, but once they are born, they are on their own and clearly someone else's problem.

Yes, I know. It isn't the "conservative" thing to require insurance companies to cover anything, but as a conservative, aren't there principles more important than just cash flow? Child labor laws were enacted for just such a cause. Perhaps child labor laws should be repealed for children with autism?

Ron Black is a consultant, blogger and commentator and creator/host of "Wild Oklahoma" radio and television.

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Gumm: The Fight For Autism Insurance

Regular readers of my column know I am fighting to help children with autism. The effort has taken the form of “Nick’s Law,” which would require health insurance in Oklahoma to cover autism spectrum disorders. Last year, we enjoyed bipartisan support in the Senate on this issue.

By Senator Jay Paul Gumm, D-Durant

Not everyone supported it, and I understand that, but senators from both parties joined hands to pass “Nick’s Law” in the Senate numerous times. In the House of Representatives, it quickly became partisan, with the majority Republicans denying the bill even a hearing.

This year, House Republicans shot down “Nick’s Law” very quickly – in hopes of washing their hands of a sticky political issue early in the session. Now, it appears Senate Republicans have decided to be as partisan as their House brethren as two separate votes – right down party lines – suggest they fear even discussing the issue.

The first vote was on a bill about the Oklahoma High Risk Insurance Pool. The pool is the “insurer of last resort,” a creation of the Legislature to provide coverage for those Oklahomans who cannot get health insurance elsewhere. It seems a perfect way to provide autism coverage.

I proposed requiring the pool to cover autism consistent with “Nick’s Law.”

The one change I made was to lower the annual cap to $36,000, the same as the Republican-sponsored Louisiana law that requires health insurers in that state to cover autism.

Instead of allowing the amendment to be considered, the author of the bill moved to “advance” the bill beyond the ability to amend. The motion to advance was approved on a staight party-line vote with Republicans voting “yes” and Democrats voting “no.”

The second vote – again, down party lines – was on a bill to create a Health Insurance Mandate Review Task Force. This task force would be horribly tilted in favor of big insurance and against consumers.

Republican legislative leaders would have eight of 10 appointments to the task force. The governor would have two appointments; the state Insurance Commissioner would be the 11th member.

I proposed an amendment to give the governor two more appointments and require they come from the consumer side of the equation. Legislative leaders and big insurance still would have enjoyed a two-to-one advantage on the task force under my amendment.

That wasn’t good enough; the author of that bill moved to advance the measure beyond amendment, which was approved on a partisan vote. Given the composition of the task force, the results it would propose are a foregone conclusion.

There will be other chances to vote on variations of “Nick’s Law” as I refuse to give up on Oklahoma’s children with autism. The question is: Will Republican members – many of whom have voted for “Nick’s Law” in the past – have the courage to vote their conscience or will they cower under pressure from their leadership?

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Autism Bill Draws Support, Discussion

Democratic Floor Leader Mike Brown, D-Tahlequah, and Rep. Joe Dorman, D-Rush Springs, today praised the passage of a bill designed to enhance services for autism in the state, but cautioned that the bill may not do enough to help families of children with this disease.

“I am grateful for the opportunity to work with Speaker Pro Tem Kris Steele to ensure this bill is as effective as possible,” Brown said. “I’ve always believed that we can craft good legislation by reaching across the aisle to share our concerns and then allow full debate by the good public servants of the House of Representatives."

Brown and Steele, R-Shawnee, collaborated on improving language to HB2027 before it was introduced on the House floor to ensure that the bill would remain in full compliance with existing statutes.

“I’ve visited with administrators at Northeastern State University, and they’re ready to implement this training program. As soon as this funding comes through, they are set to start training autism providers,” Brown added.

“This bill, however, remains only a partial solution to the greater problem of helping families of children with autism,” Brown stated. “They face greater challenges not addressed by this bill, such as paying for costly treatment for their children. Since many insurance companies don’t cover care for autism, even families who can afford private insurance may not be able to afford treatment – so how will these new providers afford to stay in Oklahoma?”

Dorman joined Brown in praising passage of the bill, but also held reservations whether this bill does enough to help Oklahoma families.

“My greatest concern is that without a way to ensure these providers a mechanism for payment, we’ll experience a ‘brain drain’ and lose them to other states,” said Dorman. “Training more autism providers is an excellent step in the right direction, but I am concerned especially for people in rural areas that they will still be unable to find autism specialists or pay for their services.”

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Benge Outlines GOP Autism Proposal

Republican House leaders today unveiled a proposal that would increase the number of therapists serving children with autism and help families access care for children with the disorder.

The proposal calls for enactment of a licensing process for national Board Certified Behavioral Analysts and enhancement of existing state programs that would train doctors to diagnose and treat autism.

But the chief legislative sponsor of a bill to end what he calls insurance discrimination against children with autism said the House GOP plan “falls short” of what is needed.

“Their plan is a step in the right direction, but it is only one step,” said Senator Jay Paul Gumm, a Democrat from Durant who is pushing for passage of “Nick’s Law.”

“Without some kind of private insurance component, the House’s proposal will fall woefully short of dealing with the epidemic of autism.”

The lawmaker said the foundation on which a comprehensive strategy to help children with autism must include insurance coverage. Such coverage, which would be required under “Nick’s Law,” allows parents to afford the advanced therapies. Further, bills like Nick’s Law in other states have been proven to be the key to creating a demand, attracting therapists to the state.

Benge said, “By increasing the number of providers, our proposal will allow market forces to alleviate the costs of autism services and increase access to care. Currently, there is a huge imbalance between supply and demand. We have only a few true providers in Oklahoma, but potentially thousands of children needing services.”

During a legislative study conducted in 2008, lawmakers learned that a shortage of trained providers has made it difficult for families to obtain autism services even when they have state assistance.

When a recent state pilot program provided families $12,000 a year to obtain autism-related services, much of the money went unspent because there were not enough professionals trained to work with children with autism.

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'Nick's Law' On Autism Disorders Passes Senate

An amendment that would require health insurance policies to cover diagnosis, treatment and therapy for autism disorders passed the Oklahoma Senate on a bipartisan vote today.

The plan, called “Nick’s Law,” will give Oklahoma families a better opportunity to fight a disability affecting more children than ever. Both Senator Jay Paul Gumm, D-Durant, and Senator Mary Easley proposed amendments to a pair of bills that were subsequently approved and sent to the House of Representatives.

The lawmakers said empowering parents and holding powerful insurance companies accountable to their policyholders is the right thing to do. Gumm said the proposal is fiscally responsible to taxpayers and morally responsible to children in Oklahoma.

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