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Autism insurance bill stalls in House panel

Monday, February 9, 2009

Legislation that would have required insurance companies to cover certain autism treatments stalled in a state House subcommittee last week.

House Bill 1588, sponsored by Del. Bob Marshall, R-Prince William, and Del. David Poisson, D-Loudoun, would have ensured coverage up to $36,000 a year for medically necessary treatments. However, the House Labor and Commerce subcommittee that heard testimony on the issue Tuesday did not vote on the bill.

In a statement, Marshall called the subcommittee's lack of action "a display of complete indifference to the Virginia families of autistic children."�

Autism is a developmental disorder that affects one out of 150 children nationwide, and its numbers are growing, though doctors still do not understand the full reason.

Dr. Susan Anderson, a developmental pediatrician at the University of Virginia, was one of the experts scheduled to testify before the subcommittee.

Anderson said she planned to "make it very clear to the General Assembly that this is a medical disorder. This is not a mental health disorder."�

The bill would mandate coverage of "only those therapies for which there is pure evidence-based support they are effective in autism," she said. Those include Applied Behavior Analysis (ABA), speech therapy and occupational therapy.

Anderson and other doctors recommend starting these techniques as soon as autism is suspected. Early intervention makes a difference, she said.

"In terms of the cost of intervention, getting that foundation for future teaching at a young age pays out in the long run in terms of avoiding perhaps some more expensive interventions later on," Anderson said.

But the way private insurance functions, "it is hard to get coverage" to treat autism, she said.

Christy Wiseman and Jason Wiseman ran into this problem with their 6-year-old son, Jarin, who has autism.

"Jason had top-of-the-line insurance, but it wouldn't cover his (Jarin's) therapy," Christy Wiseman said. The company said autism did not count as a "disease," she said, and does not have a cure.

Their doctor tried to argue with the insurance company's decision, she said, "but they still wouldn't pay for it."�

"Jarin has so much potential in him, so why stop his therapy when there's so much there?" his mother asked.

Before the subcommittee hearing, Marshall and Poisson issued a joint statement in support of their bill. They and others said medical experts, including the U.S. Surgeon General, say that early intervention can help children with autism avoid becoming wards of state.

The bill's sponsors also cited a recent study in Pediatrics, published by the American Academy of Pediatrics, that found that children with autism are much more likely to have problems accessing health care, causing financial hardship for families.

With insurance refusing to cover necessary treatments for autistic children, they argued, much of the burden falls on parents and schools to provide and pay for therapies.

At least eight other states have passed similar bills mandating insurance coverage.

"I told the seven (committee) members present that silence is not a morally acceptable response to this situation," Marshall said in the later statement. "I noted to Del. Terry Kilgore, who chairs the full Labor and Commerce Committee, that he has the authority to bring up H.B. 1588 regardless of the actions of the subcommittee. He said he would not do that."�

He encouraged Virginia residents to contact committee members and other delegates and speak out on the issue. Del. Danny Marshall, R-Danville, is a member of the full Labor and Commerce committee but was not part of the subcommittee that reviewed the bill.

"I intend to find another way to move H.B. 1588 forward," Del. Bob Marshall said in the statement. "Legislators are sent to Richmond to confront issues, not duck them."�

 

 
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