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Thursday, March 10, 2011

West Virginia Bill Progresses

A Senate Finance subcommittee has agreed to the annual benefit caps proposed in the bill when it passed the House last month. The subcommittee amended the bill so benefits would not start until age 2.

The subcommittee also exempted health plans for employers with 25 or fewer workers. It would otherwise require private and public insurers to pay for applied behavioral analysis.

This ABA therapy is considered crucial for children with autism spectrum disorder. But insurers warn that mandating such coverage will increase costs.

The bill advances to the full committee. The session ends midnight Saturday.

The Charleston Gazette strongly endorses it:

Opponents argue that insurers would just raise everyone else's rates. No doubt. But even if everyone were asked to pay another $1 a month so that children with autism could receive this treatment, how is that different from paying so that people can have heart surgery, or treatment after a car crash? Not everyone has heart attacks or car wrecks, but everyone pays to insurance pools to cover those treatments. That is what insurance is for.

Autism is a biological problem that interferes with a child's ability to develop and function up to the child's potential. Until a cure is found, the best treatment is to minimize the ill effects.

Insurers get hung up on whether this treatment is medical or educational. But patients expect to engage in physical or occupational therapy after surgery, serious illness or injury. It is an accepted part of recovery -- regaining function.

For children with autism, good, consistent therapy early enough can change the trajectory of their lives. It can make the difference between being able to talk, communicate, study and work, or growing up frustrated, isolated and dependent.