I have to ask myself why anyone working in Michigan's legislature, someone who claims to be a Christian vote against legislation that requires insurance companies to cover a condition as devastating to Michigan's families as autism. Yet that is exactly what Rochester's state representative, Tom McMillin did.
It's interesting, when a problem is personal how political ideologies go out the window. Witness former Vice President Dick Cheney, whose daughter is gay, being in favor of marriage equality.
Also witness Michigan's Lientenant Governor, Brian Calley, whose daughter has autism, was one of the main proponents of legislature requiring Michigan's insurance companies to cover autism diagnosis and treatment.
But not Rochester's State Representative, Tom McMillin. His heart is two sizes too small.
Some Facts About the Legislation and Autism
Legislation - Concurrence Vote Passed (Senate) - March 29, 2012(Key vote)
Title: Requires Insurers to Cover Autism Treatments
Vote Smart's Synopsis:
Vote to concur with House amendments and pass a bill that requires health insurers to provide coverage for autism.
- Requires all health insurance providers and health maintenance organizations to provide coverage for the diagnosis and treatment of autism spectrum disorders.
- Prohibits insurers and health maintenance organizations from doing any of the following:
- Terminating coverage or refusing to renew coverage solely because an individual is diagnosed with or treated for an autism spectrum disorder;
- Limiting the number of visits an insured individual may use for treatment of autism spectrum disorders;
- Denying or limiting coverage of treatment for autism spectrum disorders on the basis that the treatment is educational or rehabilitative; and
- Subjecting coverage of treatment for autism spectrum disorders to dollar limits, co-pays, deductibles, or coinsurance payments that do not apply to coverage for treatment of physical illness.
- Authorizes insurers to limit coverage of treatment for autism spectrum disorders to insured individuals under the age of 18.
- Exempts insurers from any requirement to provide prescription drug coverage unless the insured individual is covered by a prescription drug plan.
- Exempts short-term insurance policies lasting no more than 6 months from the provisions of this bill.
What is Autism?
Autism spectrum disorder (ASD) is a range of complex neurodevelopment disorders, characterized by social impairments, communication difficulties, and restricted, repetitive, and stereotyped patterns of behavior. Autistic disorder, sometimes called autism or classical ASD, is the most severe form of ASD, while other conditions along the spectrum include a milder form known as Asperger syndrome, the rare condition called Rett syndrome, and childhood disintegrative disorder and pervasive developmental disorder not otherwise specified (usually referred to as PDD-NOS. Although ASD varies significantly in character and severity, it occurs in all ethnic and socioeconomic groups and affects every age group. Experts estimate that three to six children out of every 1,000 will have ASD. Males are four times more likely to have ASD than females.
If autism is not treated, in many cases the child will require full time care for the rest of his or her life. The cost for non-treatment is incurred by Michigan companies (disabled children usually get lifetime medical insurance), families, and the State of Michigan. Higher state and local taxes are needed to support the intensive medical and social services, housing, transportation, employment compensations, and safety mechanisms, which are required to manage the lifelong needs of these individuals. Additionally, the cost of school supports top $60,000 per student per year, translating to a $3 billion cost to Michigan schools over the lifetime of 15,000 children with autism.
Autism insurance reform legislation passed:
Michigan recently passed legislation that would join the other 34 states and the District of Columbia that have laws related to autism and insurance coverage. 30 states specifically require insurers to provide coverage for the treatment of autism (http://www.ncsl.org/?tabid=18246). Without legislation, Autism Speaks ranked Michigan as one of the worst 10 states to raise a child with autism as it lacked insurance coverage and options for treatment are rare to find. As a result, many families have been leaving Michigan to find assistance elsewhere. Since the passage of the Autism Insurance Reform legislation, Michigan is now well on its way to going from being one of the worst 10 states to raise a child with autism to being one of the best.
The Autism Insurance Reform Legislation (SB 414 and 415) is narrow in scope; only allows licensed physicians and psychologists to diagnosis (not teachers, social workers, etc.); limits treatments to evidenced-based therapies and provides for behavior, speech, occupational and physical therapies; behavior therapy has to be provided by or supervised by a board certified behavior therapist; and provides for checks and balances including reviews by insurers and managed care cost containment practices.
SB 981 was introduced to reimburse carriers and third party administrators (TPAs) for paid claims for the "diagnosis of autism spectrum disorders" and "treatment of autism spectrum disorders" as those terms are defined in SBs 414 and 415.
This three-bill package passed both chambers overwhelmingly with bipartisan support in March, 2012.