NC Senate should approve more insurance coverage for autism

May 18, 2014 

In the United States, it is estimated that one in every 68 children is autistic. In North Carolina, it’s one in 58. Those are alarming numbers, but so far not alarming enough to move the state Senate to help families coping with the most severe forms of autism.

Last session, the state House, by a vote of 105-7, passed House Bill 498, a measure requiring insurers to provide broader coverage for the treatment of autism spectrum disorders. But the bill stalled in the Senate where members were wary of the potential cost.

Having passed one chamber, the bill is eligible to come up during the current short session. That opportunity was almost foreclosed by a Senate proposal for a one-year moratorium on all new health insurance mandates. The proposed moratorium is part of a Republican push for a study that will show how much the Affordable Care Act is costing North Carolina. (What they should look at is how much the General Assembly has cost North Carolina by resisting the health care law and refusing to expand Medicaid.)

In an impressive show of resolve and compassion, a group of GOP House members stood up for the autism bill last week when they did not attend a meeting of the Joint Study Committee on the Affordable Care Act and Implementation Issues. Their absence left the meeting short of a quorum and sidelined the moratorium.

Senate leaders may be miffed by the boycott, but what they should be is grateful to those House members who saved them from blocking a sensible, cost-effective autism bill just to indulge in another round of Obamacare bashing. With the proposed moratorium on health care mandates out of the way, the Senate should approve the bill.

The resistance in the Senate reflects objections from health insurance companies. Most insurers cover treatment of autism involving speech, physical and occupational therapy as well as diagnosis and drugs to treat symptoms. But they don’t want to be required to cover the costly behavioral therapy that has been shown to help severely autistic children learn social skills. Insurers contend that the therapy, known as applied behavior analysis, is still experimental and largely an exercise in education rather than medicine.

The therapy involves as many as 40 hours a week of one-on-one interaction. It is expensive for families, in some cases costing as much as $70,000 a year. But doctors and parents of autistic children say therapy works, and the overall costs are not a burden on premiums. The coverage mandate has been adopted in 37 states with the average impact on premiums being 31 cents per month, according to Autism Speaks, a group that sponsors autism research and promotes treatments. If severe autism is left untreated by intensive behavioral therapy, states can spend millions of dollars more providing special education and care for those with autism , the group says.

The House has stood up for the autism bill. The Senate should, too. It’s not about Obamacare and health care mandates. And it shouldn’t now be about a turf fight between the House and Senate.

It’s about giving children trapped in the isolation of their condition a chance to enter a wider world. It’s about doing the right thing.

News & Observer is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere in the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. Thank you for taking the time to offer your thoughts.

Commenting FAQs | Terms of Service