Monday, April 17, 2006

The Greenville News Supports Us

Monday, April 17

Insurance and autism
It makes compassionate and financial sense to mandate insurance coverage for autistic children.
Published: Tuesday, April 4, 2006 - 6:00 am

House lawmakers want to spend $7.5 million to fund therapy for children with autism. That's an appropriate expenditure for this disease that can severely impair a young person's ability to communicate, form relationships and adapt to change.

But the money shouldn't deter lawmakers from considering another legislative initiative requiring private insurance companies to cover autism therapy, which can cost up to $100,000 a year. The House's proposed allocation is an attempt to prevent the state mandate on private insurance from moving forward.

But the state money allocated may not be enough to provide therapy to all young people who need it. In South Carolina, about 2,000 children under 18 have autism. In addition, the $7.5 million is coming from a one-time source -- part of the $30 million the state is expected to gain from the sale of the old state mental hospital. The money might not be available next year.
Advocates argue that early intensive therapy can do wonders for some autistic children. The State newspaper quoted advocates as saying that almost half of children who get at least 40 hours of therapy a week can enter the first grade on time. Another 40 percent make considerable progress, they say.

Even though therapy may be costly for insurers, it would save the state considerable sums in the future, advocates say. An autistic child who receives insufficient treatment almost always ends up being cared for in an institution at taxpayer expense. That can cost the state up to $4 million for each patient.
Insurers, however, question the effectiveness of intensive treatment. Certainly, the mandate to cover autism would be financially burdensome for insurers, costing tens of millions of dollars just in South Carolina. Those costs most likely would be passed on to businesses and individuals in the form of higher premiums at a time when companies and families are struggling to pay for health insurance.
But compassionate consideration for children suffering from autism should persuade state lawmakers to follow the lead of the 17 other states that require coverage. Equally persuasive is the argument that early therapy could save the state millions of dollars later.
The $7.5 million House lawmakers want to use for autism treatment would benefit from the federal government's 3-to-1 match through Medicaid. That will cover many of the children needing intensive autism treatment, but not all of them. Lawmakers eventually should mandate private coverage for autistic children.


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