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Sunday, March 6, 2011

Background on Autism Insurance Coverage

At The Wall Street Journal, M.P. McQueen offers a good backgrounder on the state of insurance coverage:

An estimated one in 110 children is diagnosed with autism in the U.S., and its prevalence is increasing for reasons that aren't well understood, according to the U.S. Centers for Disease Control and Prevention. Average medical expenditures for those with autism-spectrum disorders exceed those without by $4,110 to $6,200 per year, the CDC states.

In response, at least 23 states, including Indiana, South Carolina, Arizona and Massachusetts, have passed laws in the last few years requiring state-regulated group health plans to include autism coverage, according to the National Council of State Legislatures, though many states have caps on the mandates. Most other states and Washington, D.C., have similar bills pending, according to Autism Speaks, an advocacy group. Only Oklahoma, Utah and Wyoming don't have bills requiring autism coverage on their agendas.

The Edmond Sun follows up on Oklahoma:

House Bill 1248 by state Rep. Randy Grau, R-Edmond, would have introduced coverage for children with autism and related disorders when they either don’t have private insurance or their private insurer doesn’t cover the disorder, Grau said. The high risk pool was created by the Legislature in 1995 to serve those who have been denied health insurance due to a serious health condition.

“I talked to the chairman and he just said he didn’t want to hear it,” Grau said of Oklahoma House Appropriations and Budget Committee Chairman Earl Sears, R-Bartlesville.

HB 1248 (Solomon’s Law) is named after 7-year-old Solomon Littleton of Edmond who was denied insurance coverage after contracting Landau-Kleffner syndrome. Solomon was 5 years old in 2008 when he contracted the rare neurological disease. Eric and Marci Littleton saw their twin son’s normal life deteriorate with a loss of motor skills.

Grau discussed HB 1248 this week with House Speaker Kris Steele, R-Shawnee. Steele wants to help support children with autism spectrum disorders, Grau said. But the speaker wants to delay consideration of Grau’s bill pending evaluation of a new Sooner Start program that is based on Senate Bill 135.

SB 135 went into effect in January. It was authored by Steele and state Sen. Ron Justice, said Lisa Liebl, press secretary for Steele.

Sooner Start is an early intervention and treatment program for children with disabilities and developmental delays age birth to 3. Solomon was 5 years old when he contracted Landau-Kleffner syndrome.
Also see earlier posts on Oklahoma scholarships for kids on the spectrum.