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Autism diagnoses prompt bills on insurance coverage

Tuesday, January 19, 2010 | 9:03 p.m. CST; updated 12:00 a.m. CST, Wednesday, January 20, 2010
State Sen. Jason Crowell, R-Cape Girardeau, (presiding and seated center) listens to witnesses testifying in favor of a state Senate bill on Tuesday in the statehouse. The bill would require health carriers to provide coverage for the diagnosis and treatment of autism spectrum disorders under certain conditions. Missouri state Sen. Scott Rupp, R-Wentzville, is sponsoring the bill.

JEFFERSON CITY — Missouri legislators were warned of an impending "autism tsunami" Tuesday as committees in both chambers heard bills mandating insurance coverage for the disorder.

Both versions of the bill referred to speculation about an increased number of children diagnosed with autism, yet how much insurance premiums will increase remains an issue.

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A similar bill to mandate insurance coverage for autism passed in South Carolina. Lorri Unumb of South Carolina, mother of an autistic child and an Autism Speaks advocate, testified that Missouri should do the same.

"There is a huge autism tsunami about to hit the state of Missouri, and it's going to cost the state an extraordinary amount of money in special education, adult care and institutionalization if this current generation of kids does not get the treatment that it needs," Unumb said.

Neither the House nor the Senate took any action on the bill Tuesday. Committee Chairman Sen. Scott Rupp, R-St. Charles County, said action on the bill could take place as early as next week.

Proponents of the bill highlighted the increased diagnosis of autism nationwide, based on active screening programs and more awareness.

Members of the opposition pointed out that the number varies from one in 60 to one in 150 children.

The greatest concern voiced by representatives of insurance companies opposing the bill is that mandating autism coverage would push premiums too high for their customers, especially for small businesses.

While proponents of the bill said a boost in insurance premiums would be minuscule, statistics show an increase of up to 3 percent per member per month, said David Smith, a lobbyist for Anthem Blue Cross and Blue Shield.

The insurance company is interested in working out a compromise where children are covered and premiums remain affordable, Smith said.

"We, as the insurance carriers — not only this year but also last year — are not necessarily in opposition to the concept of providing care for kids, but we're looking at more of a logical side than the emotional side," Smith said.

The Missouri legislature must first determine whether the increase in autism is a tsunami or a trickle, said William Shoehigh, representing United Healthcare Inc. He asked both committees to consider exempting small businesses.

The bill was expected to pass easily through both the House and Senate during last year's session, but Republican Speaker Ron Richard unexpectedly derailed the House version last April after the Senate's quick passage. Richard was criticized by Rep. Paul LeVota, D-Jackson County, after failing to make the autism bill the first piece of legislation to be debated.

When the bill was blocked last April in favor of other health measures, Richard's office told Missouri Digital News that it had insufficient support.

Gov. Jay Nixon has endorsed a mandate for autism insurance coverage.


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Comments

Rena Kuster January 19, 2010 | 11:22 p.m.

"The greatest concern voiced by representatives of insurance companies opposing the bill is that mandating autism coverage would push premiums too high for their customers, especially for small businesses.

While proponents of the bill said a boost in insurance premiums would be minuscule, statistics show an increase of up to 3 percent per member per month, said David Smith, a lobbyist for Anthem Blue Cross and Blue Shield.

The insurance company is interested in working out a compromise where children are covered and premiums remain affordable, Smith said.

THIS IS SUCH BS! My husband and I are self-employed parents (the small business owners referenced above!) of 4 children. We have Anthem BC/BS as our insurer and have for many years. Each year, Anthem's premiums increase by a minimum of 4%! We currently pay $1850 monthly with $30 copayments for office visits and $40 for prescriptions!! Insurers are making profits EVERY year yet are unwilling to sacrifice for children with autism? Our son has high-functioning autism and has received services for six years -- mostly uncovered. Fortunately, we've been able to pay out-of-pocket for his services and our school district does a fantastic job with him. However, with the economy in the state that it is, we're no longer able to provide services that he NEEDS. Shame on Anthem and all of the other insurers against this policy!

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