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Sunday, June 6, 2010

Michigan Mandate and the Costs of Treatment

The Detroit Free Press reports:

State Sen. Randy Richardville, R-Monroe, vice-chairman of the Economic Development and Regulatory Reform Committee, has scheduled informational hearings, partly in response to two bills that have passed the state House but must be considered by the Senate.

Meanwhile, the fight over costs has wound through the courts, too. Blue Cross Blue Shield of Michigan has settled two cases -- one as recently as last week -- with families who asked the courts to force the insurer to pay for at least part of the costs for past behavioral therapy for their autistic children.

It's not that Blue Cross didn't want to cover the costs for autism treatments; in fact, it offers an option to employers to buy that coverage, said Helen Stojic, spokeswoman for Michigan's largest insurer. To keep plans affordable, insurers need to offer flexibility rather than meet state mandates, she argued.

The debate brings into focus the exorbitant costs for treatment and the lengths to which families will go to pay them -- draining retirement plans and college funds, selling homes and moving out-of-state to find insurers who routinely cover such costs.

At the end, the report tells of one child who made striking progress and it ends with an apt summary:

Such stories don't surprise Pamela Lemerand, project director at the Autism Collaborative Center at Eastern Michigan University, where she knows that even the center's low-cost services -- just $65 an hour compared with some that top $100 -- are still out of reach for some families.

"Even poor people can go into an emergency room and get service, but in this instance, your child is out of luck."