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Tuesday, October 11, 2011

Followup on the California Mandate

In the wake of the California mandate, David Lazarus writes at The Los Angeles Times:
"The only people who don't think of behavioral therapies as a medical treatment are insurance companies," said Kristin Jacobson, co-founder of the Alliance of California Autism Organizations and a leading proponent of the new state mandate.

"The rest of the medical community is united in seeing these treatments as medically necessary," she said.


Marcia Eichelberger is president of the Autism Society of California and mother of a 19-year-old with autism. She said there's no question that receiving behavioral therapy has given her son a chance at independence and helped keep him from even costlier institutionalization.

"Had we not done these types of interventions with our son, his frustration level would have been so great that he couldn't have stayed at home with his family," Eichelberger said.
The association also emphasizes that the new mandate for coverage will cause premiums to increase for individuals and employers.

"At a time when lawmakers voice concern about rising healthcare costs, it makes no sense to sign a new law that will raise healthcare costs by $850 million a year," said Patrick Johnston, the group's president.

That sky-high number comes from a study commissioned by the industry group. A separate study for the state Legislature by the California Health Benefits Review Program estimated that the cost to insurers of implementing the law would be closer to $93 million.

“Courage and common sense have prevailed as Governor Brown has chosen to side with California families and taxpayers, rather than the health insurance lobby,” said Autism Speaks Co-founder Bob Wright. “Autism Speaks singles out Senate President Pro Tem Darrell Steinberg whose unwavering leadership and commitment led to this success.”

Authored by Senator Steinberg, SB.946 clarifies settlements negotiated by the Brown administration last summer with two major health plans that behavioral health treatments, such as applied behavior analysis (ABA), are eligible benefits with no caps on age or amount of benefits. The settlements initially appeared to provide the needed coverage, but contained a flaw that substantially negated their intended impact, requiring the legislative remedy provided through SB. 946.

The law will start taking effect July 1, 2012 as health plans renew policies and sunset in 2014. By virtue of the early intervention provided through ABA, California taxpayers are expected to save $140 million a year in special education and social service costs, according to an independent analysis by the California Health Benefits Review Program. In addition, the improved access to ABA therapy could create at least 20,000 new jobs.