Wednesday, June 13, 2007

One Week Later

Lawmakers mandate autism coverage
General Assembly sends strong message of support for disabled children by overriding governor's veto

Published: Wednesday, June 13, 2007 - 2:00 am

State lawmakers recently handed Gov. Mark Sanford a dramatic defeat by voting unanimously to override the governor's veto of a bill requiring private insurance coverage for autistic children. Lawmakers were right to do so.

Autism, a disease that can severely impair a young person's ability to communicate, form relationships and adapt to change, was the only neurological disorder not required to be covered by private insurance in South Carolina. The law will require insurance to pay for treatment for children, age 16 and under, up to a maximum of $50,000 a year beginning in July 2008.

Sanford, in his veto message, raised legitimate concerns about the autism mandate increasing the cost of insurance for everyone else. He said the law would add $10.5 million in costs to the State Health Plan next year and about $48 annually to private insurance premiums paid by South Carolina families.

But state lawmakers argued rightly that the state may save millions by investing in early intervention. An autistic child who receives insufficient treatment sometimes can end up being cared for in an institution at taxpayer expense. That can cost the state $4 million to $7 million for each patient. Intensive early therapy, however, can do wonders for some autistic children. Advocates say that about 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.

That therapy, however, can cost up to $75,000 a year, putting it out of reach of many families with autistic children. Advocates say families across this state are forced to get second mortgages on their homes or face bankruptcy trying to provide the intervention their children need. Or they face the heart-wrenching experience of placing their children in group homes or institutions -- although there's often a 15-year waiting list for such institutions.

In his veto message, Sanford reiterated his support for Health Savings Accounts and the ability of the market to create "better products and services." Many South Carolinians no doubt agree in principle with Sanford when he extols the free market, but it's hard to see how health savings accounts can help a family faced with therapy costing up to $75,000 a year.

Even as he was vetoing the bill, Sanford said: "My prayers go out to any family afflicted with any of these (autistic spectrum) disorders." Given that sentiment, it's unfortunate Sanford was unable to follow the lead of state lawmakers in approving the bill. At least 17 other states require insurance coverage for autistic children. South Carolina appropriately will join those states in providing a better life for autistic children.


Anonymous Anonymous said...

I think a fair question to ask Gov. Sanford is, "How do you make a distinction between the costs of autism and the costs of other neurological disorders that presumably made it into the bill?" If autism is $10.5 million and $48 in premiums and these are your data that support not including it in the bill, then other disorders must cost the taxpayers less. I'm not sure how you make the decision to include one and not another based on that data alone.

I agree that the free market produces more competition, better services, and ultimately lower costs. But currently, because treatment is so expensive, there's not enough true demand for autistic therapy. Indeed, there's a lot of need for therapy, my nephew is autistic for one. But if those parents don't have the dollars to drive demand for those services in the "economic" sense, then providers won't be entering the market to drive better services at a lower ultimate price. In effect, the demand for autistic therapy services is "locked" up until a bill like this comes along to serve as a catalyst for the free market to take it further.

Having said all of that, no matter the cost to include autism in the bill is the right thing to do.

4:54 PM  

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