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Monday, July 18, 2011

Views of the New York Autism Mandate Bill

The New York Post opposes it:

Albany's new stealth tax hike comes via a bill passed last month that requires insurers to provide coverage for "autism spectrum disorders."

And though the state wouldn't directly collect the "tax," employers nonetheless would have to pay it just the same -- in the form of higher insurance premiums for workers.

For lawmakers, it's a win-win-win.

* They get to play the part of the white knights -- championing "compassion" -- for having rushed in to mandate a range of medical, psychological and educational services for ASD kids.

(Who, after all, isn't moved at the thought of a family with an autistic child -- and no insurance for proper care?)

* They get to suck up to a host of special-interest groups -- the autism-treatment industry, families with autistic kids, big-government liberals, etc.

* And all the while, they can pretend that none of it will cost New Yorkers a dime in new taxes.

The truth? Insurance analysts say the bill could raise health-insurance premiums 1 percent to 3 percent.

Businesses will tack the extra costs onto the price of their goods or services, just as they do with sales tax. New Yorkers will pay -- even if they don't realize it.

That's not all. State and local governments throughout New York will face a higher tab for their own employees' insurance -- borne by . . . taxpayers.

"At a time when the state has been looking to rein in the cost of health care, we shouldn't be imposing new costs," says Leslie Moran, of the New York Health Plan Association.

Yorktown Patch reports:
"Studies have shown that for every 1 percent increase in the costs of health insurance, 30,000 New Yorkers lose their coverage entirely, as smaller employers are no longer able to afford such coverage for their workers," said Thomas Faist, Esq. in a legislative statement for the Empire State Healthcare Coalition and the New York State Association of Health Underwriters.

The statement also says that laws are already in place that require health plans to cover autism treatments, and that under the Employee Retirement Income Security Act of 1974, self-funded health plans, providing coverage for 40 - 60 percent of New Yorkers, wouldn't be subject to the mandate.

Feist writes that under the bill state insurance programs like Child Health Plus, Healthy NY and Family Health Plus "are not subject to all of the state mandated benefits that are required of the private, commercial plans and policies."

The bill states that health premiums are expected to increase by about 2 percent, but an analysis by advocacy group Autism Speaks estimates that the increase would be 0.27 to 0.63 percent after six years of the coverage mandate being in place.

The analysis also found that while New York would spend more for premimums on state health insurance programs like the New York State Health Insurance Program (NYSHIP) and Child Health Plus, it would ultimately save $13 million.

The savings, the analysis said, would come from a decreased demand for services from Medicaid, the Early Intervention Program and services provided by the Office of People with Developmental Disabilities. Over time, better access to therapies early in a child's life is expected to provide relief to school districts that may see less demand for intensive special education services as more students are able to be included in traditional classroom settings.

Judith Ursitti, Director of State Governmental Affairs for the advocacy group Autism Speaks, says that many parents of autistic children struggle with insurance denials for medical services that may not be provided by schools to the extent that a child needs to see improvement in his/her condition.

"Over and over again, when families get the diagnosis the supports in place say, 'Go to school and they'll do everything for you.' Most kids need both school and medical supports," she said.

"When an autism diagnosis is disclosed to a health plan, just about everything related to autism treatment will be denied," Ursitti said. She noted that people outside of New York whose insurance companies are based here would also see the benefits of the pending legislation.

"[Insurance companies] will always deny ABA, deeming it experimental or educational. When evaluations are needed—many times doctors prescribe speech and occupational therapies—health plans will cover only 10 visits, saying that it's not a form of rehabilitation and that it's not medically necessary."