Insurance Coverage for Autism -Tom McMillin's Heart Is Two Sizes Too Small, Said No To Insurance Coverage
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.
Highlights:
- 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.
Candy
10:11 am on Sunday, September 23, 2012
Bruce, great piece. Yet another reason not to vote for Tom McMillin.
Janice Harding
10:13 am on Sunday, September 23, 2012
Thank you, Bruce, for speaking out on this topic. You might also add that early treatment and interventions raises the outcomes for those with autism, increasing the chances that they will become productive members of society in the future or require less intensive care later in life.
Erin
11:35 am on Sunday, September 23, 2012
RE: how the personal reverses political ideologies - an important addition -
Nancy Reagan became a strong advocate for stem cell research after President Reagan was diagnosed with Alzheimers. She pushed for the reversal of the GWB administration ban and praised Obama's move to do just that.
RE: McMillan. I too am confused as to his continual false choices between sound science, good economic policy and moral values. The contorted dichotomies he sets up are increasingly dizzying to me. I cannot follow his reasoning.
The Autism coverage is a perfect example. In my view, having insurance cover at least some of the autism treatments would take financial pressure off not only hard working Michagan parents, but also many school districts that are now providing much of that type of support and special services. To me, there's a strong economic argument. And, since when does helping those in need NOT fit in with Christian values?
Timothy Maurer
2:35 pm on Sunday, September 23, 2012
Tom isn't working for hard working Michigan parents. SB 415 was cosponsored by Senator Marleau, supported by the Dems and the Repubs, Governor Snyder, etc, etc. Tom works for the companies and out of state interests that cut him checks.
Laurie
3:51 pm on Sunday, September 23, 2012
As a parent of an autistic child I'm saddened to learn about this. Mr McMillin will not get my vote.
Eve Ts
5:46 pm on Sunday, September 23, 2012
McMillin makes me sick. You couldn't pay me to vote for him.
AutismParent
7:53 pm on Sunday, September 23, 2012
McMillin has made this town look like Howell. Maybe he should run for state rep there. I'm sure he denies the existence of autism.
Will Hanson
7:59 pm on Sunday, September 23, 2012
Excellent article Bruce. Your commentaries have been missed. Hope to see more of these enlightened articles in the future. Thank goodness that we have a strong candidate running against McMillin so we can put an end to this embarrassment.
Paul Sr.
8:19 pm on Sunday, September 23, 2012
Fealk is a crazy liberal but he is spot on when it comes to McMillin. Tom McMillin is the worst kind of extremist. Runs with hate group leaders, hates public Ed because gay kids are protected from bullying. Great comment from the parent of an autistic child. McMillin belongs in a different town or state.
Kristin Bull
9:32 pm on Sunday, September 23, 2012
It looks like 26 representatives voted against the bill in the state House? I would be interested in hearing what some of their reasonings were for voting against this bill. Also, for what it's worth, it looks like this bill was sponsored, in part, by Rochester's state Senator, James Marleau.
Bruce Fealk
5:42 am on Monday, September 24, 2012
Kristin, why don't you set up an interview with Tom and ask him. Better yet, ask him at the debate on October 3 at the Rochester Hills City Hall at 7:30.
Erin
8:40 am on Monday, September 24, 2012
Oh yes, debate schedule please.
Mike Reno
9:20 am on Monday, September 24, 2012
This would’ve been far more interesting if it was designed to examine both sides of this 6-month-old issue, rather than merely serve as a personal diatribe against Tom McMillin during election season.
I have not looked into this issue at all. I cannot begin to understand the complexities – and cost – of raising a child with autism. Nor am I familiar with the particulars of this bill or its cost.
But this is nothing more than a blog lynching of Tom McMillin.
Haters… back off. I am not defending Tom’s decision. I simply don’t know enough about the issue. But I’m smart enough to see there are two sides.
It took no effort to google “autism votes Michigan” and see that the counterpoint is the overall open-ended cost to Michigan taxpayers. Should the government (meaning taxpayers) financially cover all of the awful, sad things that happen to people. And if they do, should there be any limits. (Cont.)
Bruce Fealk
5:50 am on Saturday, October 6, 2012
Mike, why don't you take it from one of your own, Brian Calley. It is interesting when issues affect Republicans on a personal issue, they turn liberal.
Mike Reno
10:34 am on Saturday, October 6, 2012
Perhaps there is some truth to that, Bruce.
But the problem is that if EVERYONE looks to the government to solve their problems and cover every financial hardship, then who is going to pay it?
The problem is not this particular issue per se... it's that there are HUNDREDS of these sorts of situations. Individually they may each have a very persuasive rationale for funding them. But when you can't say NO to any of them, then they will collectively bankrupt us.
Again, I'm sure your someone will twist my comments into suggesting that I am somehow against kids with Autism... and I'm not.
But I am very concerned about the underlying philosophy that the government should assume responsibility for everyone's hardship.
North Hill Mom
11:19 am on Saturday, October 6, 2012
The autism bills will save this state money in the long run. Early intervention treatment coverage will increase the probability that people with ASD can lead productive lives. Nothing liberal about them.
Mike Reno
9:21 am on Monday, September 24, 2012
(cont.) A little reading revealed that a number of Michigan legislators sought to start the program, but start it with a financial cap. Others sought to include “sunset” provisions, meaning that we should try the program for a fixed period of time to see if it was accomplishing its objectives.
And they are trying to do this, understanding that their actions have financial consequences for all of us, especially given the tight budget situation in Lansing, and the competition for scarce dollars among a number of very worthy programs.
So perhaps they are simply trying to balance programs, or construct prudent legislation, and are not necessarily opposed to helping families with autism. Their no votes might be because of the FORM of the legislation, and not the legislation itself.
Trying to argue that someone’s “heart is two sizes too small” – taken from the Grinch Who Stole Christmas – can only be countered by pointing out that Santa makes his gifts with magic – and doesn’t need to worry about costs… a fact that seems lost on those that simply want the government to fund everything.
AutismMom
9:33 am on Monday, September 24, 2012
Whether he is a liberal or a conservative, McMillin should have voted YES if he cares about the state's budget. This was a win win vote. Early intervention is key. Great article.
Bruce Fealk
9:33 am on Monday, September 24, 2012
Mike, why is a staunch conservative like Lt. Governor Brian Calley be in favor of this legislation, but not a so-called Christian like Tom McMillin?
Alex Freeman
10:04 am on Monday, September 24, 2012
Mike Reno's alter ego speaks!
Alex Freeman
10:13 am on Monday, September 24, 2012
McMillinwatch.com
Walter Creamer
10:40 am on Monday, September 24, 2012
Mr. Reno, while I personally am unaware of your health needs I am sure you can understand the burden these families experience when hearing their child has Autism. Even though you say you are unfamiliar with the legislation you give many reasons to support the McMillin decision to vote no. I am perplexed as to why Rep. McMillin never seems to be able to answer these questions for himself when asked at public meetings.
I also find it odd that you feel you can tell the "haters" to "back off". His record speaks for him and he should be the one to defend it. Rep. McMillin continues to fail the citizens he represents when it comes to decisions that affect the heart of our community. Autism, schools, LGTB community, bullying, and anything that has to do with human beings seem to be unimportant. McMillin's focus on barbers, light bulbs, and golf courses speak volumes to the type of person he is, and what is important to him.
Mr. Reno giving aid to families with devasting expenses is not like Santa. As long as I am able I will be more then happy to help those who are faced with such a burden. McMillin a Grinch, yes I do believe he may be. What is more important to you, things or people? I guess we all make choices that will deem our fate. I will stick with the human side and be happy with less in my bank account.
Marcus Burger
11:18 am on Monday, September 24, 2012
Walter, Mike seemd very fairminded on the issue:
"It took no effort to google “autism votes Michigan” and see that the counterpoint is the overall open-ended cost to Michigan taxpayers. Should the government (meaning taxpayers) financially cover all of the awful, sad things that happen to people. And if they do, should there be any limits."
Would you stick with the human side and have "nothing" left in your bank account? Be reasonable, we can't fully fund every problem in society with no regard for fiscal responsibility.
Joshua Raymond
11:23 am on Monday, September 24, 2012
This is a tough issue. Having friends and family affected by autism, I'm glad they will get help. Having other friends with depression, bipolar disorders, schizophrenia, and anxiety disorders, they still aren't covered.
For many, another question arises as well. Should the government be in the business of regulating what insurance must provide? Or should it be more of a free market with employers and employees choosing plans that contain the coverage important to them?
Lately it seems that the government wants to micromanage health insurance. Some object to items the government has required covered. Others may object to the increased cost of health care as each requirement costs individuals more. For some, these additional costs may mean the difference in whether they can afford to buy health insurance. Is it right for some to lose all health insurance because the government mandates coverage in certain areas?
I know individuals who currently only have catastrophic health insurance. Some are past childbearing years and do not need coverage for autism or contraception, another recent government mandate. Is it right that they can't afford health insurance to cover heart and arthritis needs because of required coverage they won't need?
One person wrote "As long as I am able I will be more then happy to help those who are faced with such a burden." What about those who unable to do so?
Brian Kirksey
5:16 pm on Sunday, October 7, 2012
The free market concept works when the "market" is made up of free market economies. We are in a world market, made up of many other countries...the Ayn & Milton theory only holds true when you do not have oligopolies, state run corporations (China)...
Using the free market mantra is akin to a child asking for a unicorn for Christmas, both of which sound nice but are usually uttered by people who have no idea what they are talking about.
The free market as it relates to health care is not dominated by market participants, had individuals been able to buy their own health insurance, instead of purchased in pools by employers...then the marketplace might have worked. However, generally the people that make the decisions do not care about anything but the bottom line. In policies in which the individual participants get to choose (i.e. unions, etc) these policies generally include many of these coverages, and people are willing to pay for more.
Paul Sr
11:25 am on Monday, September 24, 2012
Gay teens committing suicide everyday and McMillin puts out 5039. Fiscal responsibility isn't Tom's only objective. Shame on him.
km
5:31 pm on Monday, September 24, 2012
Good to know, now I know who I won't vote for. Anyone who votes against anything that helps special needs children and their parents will never get my vote.
Scot Beaton
11:09 pm on Saturday, October 6, 2012
Though I love to read -- both sides -- our community's opinion of State Representative Tom McMillin... Rochester Hills does not give a damn who is their State Representative -- they just care what political party they are affiliated with... just look at the facts.
http://rochester.patch.com/blog_posts/sad-but-true-c1f0e37f
Brian Kirksey
5:08 pm on Sunday, October 7, 2012
So Scot should we just roll over and die? Or maybe hold our nose like the other lemmings...because there is an R after his name. I will fight to the last moment to make sure McMillin does not stink up my hometown anymore than he has already. McMillin walked out of our PTA meeting on Friday, because he refused to answer questions or explain his positions. Joanna got a standing ovation. McMillin walked out right after the debate, didn't speak to one member of the audience. MCMillin is not from here, he moved here to run for the vacant seat...he's prepping for a senate run next hence his support for the McLaren Hospital at Sashabaw an I-75 (which is in our senate district). He's a political squatter, and could care less about our area, our citizens, our schools.
Mike Reno
5:39 pm on Sunday, October 7, 2012
The PTA has become a front for the union, which is why Joanna is so well received.
That "legislative committee" could care less about listening to Tom's positions. All they want is a pledge for more money and the elimination of choice.
There is nothing wrong with advocating for those positions. However, it is pretty pathetic to snag the PTA name, and try to pretend that the position is backed by some noble cause.
And at one time the PTA at least pretended to be apolitical. Glad they've tossed that charade out the window.
Brian Kirksey
6:29 pm on Sunday, October 7, 2012
Mike: Funny I did not see you there on Friday or any meeting in the last 24-months? Pulling it out of the clear blue sky because it supports your party line...maybe you could tell us how much you love McMillin again like you did at the debate. The PTA is not a front for any group, except our children and our community, and this man stands in the way of both. He has embarrassed us on the national stage (HB 5039), and given special favor to all special interests (who also happen to make up for over 90% of his campaign contributions and only 3% comes from within his district). I could have cared less about McMillin until his actions on charter schools. I'm not against charter schools or cyber schools...but I am an economist by trade, and I can see disaster from a mile away. Granting unlimited caps on charters and cyber schools, is reckless and only provided for as a boon to his special interest groups.
Mike Reno
7:16 pm on Sunday, October 7, 2012
I haven't heard led zeppelin live lately either, but I pretty much know what it would sound like. The story there hasn't changed in years.
And I did hear about the meeting. All of you attacking him for supporting choice. His rebuttal was confusion over why parents would be opposed to choice. The explosion that followed from the pro-monopoly crowd.
You can believe holding kids hostage in public schools might be best. I've heard the argument a thousand times. Allow them to leave, and they will leave in droves. It will harm those who stay behind.
Personally, I find it amusing that those who want to restrict choice have such little faith in the schools. If you think they are so good... then why do you believe all but a handful would leave?
You can make your straw man "for profit" argument in an attempt to fool people into believing choice is bad... but it's not going to work on those of us who want what is best for children.
Brian Kirksey
8:43 pm on Sunday, October 7, 2012
Mike
Sometimes I wonder when you end and McMillin begins...if I didn't see your love fest question at the debate for McMillin I'd wonder if I'd ever seen you two in the same room together, starting to wonder if you were the same person. So parents that are active in their PTA, join a board to help their school and meet at the RCS building monthly all happen to subscribe to the same misleading front to support a union (of which none belong to)...what is the statistical chance that each school picked the one person that subscribed to the same ideological principle.
Had you been there Mike, you would know that McMillin refused to answer if he supports mandatory school of choice. Then asked why he favored unlimited uncapping, he also refused to answer instead kept singing his mantra "what's wrong with choice". He also refused why he would allow the school aid fund to be raided, and not change funding from k-16 to k-12, as it was intended.
Brian Kirksey
8:51 pm on Sunday, October 7, 2012
In regards to Charter schools, I do not have a problem with charters in areas that need them, however I have a big problem with unlimited uncapping. While you bring up keeping kids hostage, our $7,878 per pupil pays for transportation. Charters are not required to provide transportation, yet under the same per pupil the public would be required. So who's tapping who, if a parent cannot afford or is unable to transport child to and from school. Under the same per pupil funding, the public is required to plan to accommodate all children in the district for up to 20-years in advance. Public has to ensure buses, teachers, buildings and infrastructure can accommodate this future growth... Charter only has to accommodate capacity, whatever they choose that to be. Both do so with he same per pupil funding.
Brian Kirksey
8:59 pm on Sunday, October 7, 2012
Public is restricted to the state's per pupil fund, a charter gets whatever per pupil number is transferring (wait that sounds like vouchers, didn't we vote that own) in. Charter can use the extra money saved from bussing, infrastructure to support marketing toward whatever district has the highest per pupil. So back to the original hostility toward McMillin, he says he wants to give parents choices, however he does not care for the choices we have already made as parents. It seems unless the choice supports his special interest our choice ceases to matter.
Joshua Raymond
9:50 pm on Sunday, October 7, 2012
Brian, public schools are not required to provide busing either. Grosse Pointe does not. RCS has often threatened to cut busing. Infrastructure costs for charter schools should be similar too.
Many of us do want other choices. The IA has limited spots and RCS doesn't appear to want to start one, so why shouldn't a charter IB school form?
A standard charter school in RCS probably won't attract many students. But a STEM, arts, IB, vocational, or gifted school would. RCS has the ability to create these types of schools, but will they unless they might lose students? They haven't shown an inclination to do so yet. As an economist, you understand that competition is one of the strongest forces in modifying organizational behavior.
Marianne Maurer
9:19 pm on Sunday, October 7, 2012
Brian, no one could have said it better. Joanna is the clear choice is representing the citizens of District 45. Joanna is not one sided and will listen to all, she is not a political puppet and will vote always with her constituents in mind. We have not had that for many years and now is the time to make it happen.
Once again we hear how McMillin was attacked by someone at a public meeting conducted by those who he is supposed to represent. I'm not sure why asking questions of the man who voted on certain proposals at the state level representing us out of line? When Rep. McMillin is present are we just suppose to “Smile and Wave?”
Richard Happening
9:38 pm on Sunday, October 7, 2012
No Marianne, you are "supposed" to smile and wave.