Insurance industry opposes mandated autism coverage
23 04 08 - 12:06
By JIM SAUNDERS and ANNE GEGGIS
Staff Writers
TALLAHASSEE -- With families struggling to pay for costly treatment, Florida lawmakers are debating proposals that could lead to health-insurance coverage for autistic children.
The House and Senate this week are moving forward with plans that could force health insurers to cover autism and possibly funnel more families into a state insurance program.
But the issue is wrapped in concerns about increased insurance costs that have forced many businesses to drop or scale back coverage for their employees in recent years.
Supporters say treatments such as speech therapy, occupational therapy and physical therapy can be critical for autistic children, particularly if the condition is diagnosed early in their lives.
"They aren't rocking back and forth," Rep. Ari Porth, D-Coral Springs, said in describing how children benefit from treatment. "They become verbal. They can be mainstreamed into classrooms."
The insurance industry is fighting a Senate proposal that would require many large health plans to cover autism treatment starting Jan. 1. The requirement would not affect small businesses or people who buy individual coverage.
Sam Miller, executive vice president of the Florida Insurance Council, said "assistance needs to be provided" to families with autistic children. But requiring insurance plans to cover it would drive up the overall costs of coverage.
The full Senate is scheduled to take up the proposal today and could vote later in the week. Gov. Charlie Crist also has been an outspoken supporter of requiring insurance coverage for autism treatment.
A key House panel, meanwhile, approved a plan Tuesday that takes a different approach. That proposal would try to help children with several types of disabilities -- not just autism -- and also would allow families to buy coverage through the state's KidCare insurance program for children.
Under the House proposal, private insurers would negotiate agreements with the state about providing coverage. If insurers don't reach agreement, they would be required in 2010 to start offering coverage that would screen children for developmental disabilities and provide therapies.
But some officials worry about the cost of the House proposal. Along with opening the KidCare program to more families, it also would try to increase other educational and health services.
"They (Houses leaders) are adding a lot of other issues, which are good issues," said Senate sponsor Steve Geller, D-Cooper City. "But they're not funding them."
The high costs of treating autism have hit people like Kathy Snyder of Port Orange. She signed up for a credit card just so she could charge the last $2,000 treatment of intensive therapies needed by her son, C.J.
The 10-year-old's parents have noticed that he's been regressing again, but their credit is almost entirely used up. If things don't change by June, the family will lose its house.
"We're having a horrible time," said Snyder, who believes her son needs therapies that include medicine.
But the Snyders were somewhat lucky, compared to many families. They qualified for a state program that covered C.J.'s evaluation, speech and occupational therapy.
Lynn Sinnott, executive director of Easter Seals of Volusia and Flagler Counties, applauds any effort to have private insurance cover more services autistic children need.
But Sinnott is concerned legislation might not require insurance companies to provide the full spectrum of needed services.
"Autism is a developmental disability, and it requires a significant amount of time working with a child to help them maximize their abilities," she said.