Monday, May 16, 2011

Paying for autism, can we really afford it?


Disclaimer:  My desire is to keep Parenting Autism focused on parenting subjects but often parenting a child with autism and politics blur the lines and I have to discuss the boarder implications of policy decisions.  Thank you for your continued support.

Over the last few months I have been working with a group of parents and professionals (VT CAIR) on lobbying the Vermont legislature to not repeal the autism insurance reform law that passed and  was signed into law  last year.   ACT 127 (aka Autism Insurance Reform) mandates insurance companies and Medicaid to pay for autism services (behavioral therapy, occupational therapy, physical therapy, speech therapy) for children 18 months old to six years old.  After last session we felt good, we got some needed legislation passed with some concessions but that is politics, right? 

Then we went into the current session (2011) with a new Democratic Governor and we thought, great!  ACT 127 was ready to expand to include individuals above six years old, but we got stopped right on the State House steps.  Governor Shumlin and the Democratic house and senate had not put the money into the budget to fulfill their Medicaid commitment and their best option was repealing ACT 127.  We said no, no, we will compromise and this year we will take just private insurance ($.70 a month per premium holder) and then next year we can implement Medicaid coverage.  Even that got months of debate.

This is where I have problem, whether it is a political, moral, spiritual, or intellectual problem I am not sure, you can decide.  Here is my dilemma: for the price of an apple every month we decided children with autism (and their families) are not worth the medical treatment they deserve and need. 

How can this happen in a liberal, New England state in the richest country in the world?  I don't know.  The political, cynical side of me understands that the vulnerable are always targeted in tough economic times, but the hopeful side fights back with confusion.  How did our nation, the great "melting pot", arrive here, where children are not getting medical care they need.  We are all responsible because for far too long in this country we turn the other way and say, "well, that's not my problem."

We get consumed with our busy lives and end-up walking around with blinders on, not seeing that our neighbors need help.  This is not a Vermont problem.  Accessing proper treatment for children with autism exists all across our nation.  Some states are slowly passing legislation to mandate insurance companies to pay for autism services, but more needs to be done.

The longer we wait the higher the price tag.  Not just in the children getting denied access to healthcare but in real dollars and cents.  According to the Autism Society of America, " (the) cost of lifelong care can be reduced by 2/3 with early diagnosis and intervention."  As a society we are making a choice to limit opportunities to children with autism and to assume the skyrocketing cost of adult care unless we look at our fellow citizens and take care of each other.

Related blog post:  Vermont State House Passes Autism Insurance Bill


CR Petersen said...

The most effective treatments for autism, whether it’s a behavioral model such as ABA and EIBI (ABA model for young children with autism) or a developmental model such as DIR Floortime or P.L.A.Y. or a combination such as Denver will all require substantial parental (or other primary care provider such as a grandparent in some cases) involvement. This is the absolute truth whether you are talking about autism or a behavioral disorder not attributed to autism. In almost any case, if the parents or primary care providers are not intricately involved in learning and providing the therapy, even if there are great gains in one location or for a time, as soon as that therapy is gone, much of the gain is also gone. There are many reasons for this; but it is the truth. With substantial parental involvement too, the cost is often reduced.
See: for more information
CR Petersen M.Ed

foreign languages for children said...

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