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Wednesday, March 5, 2014

Autism Policy in California: Forward and Back

In Sacramento, KXTV reports on a hearing of California's Senate Select Committee on Autism and Related Disorders concerning the state's insurance mandate.
More than two years after the new law passed, California legislators met Tuesday for a closer look at their policies with a focus on one particular unintended consequence. While access to the treatment has significantly expanded, some parents have incurred punishing costs for therapy that can be as much as 40 hours per week. That can mean thousands of dollars each year to pay their share of the treatments.

"They can't afford it because of the co-payments or they also can't afford it because of the deductibles," [autism mother Michelle] Heid said.
"The co-pay issue is a real issue as is the deductible issue, and that's one of the things we're going to examine in depth," Senator Darrell Steinberg said just before chairing Tuesday's committee hearing.

At California Healthline, David Gorn writes: of an Autism Society of California survey:
According to the survey, almost 20% of families receiving autism therapy treatment at regional centers have cancelled the health insurance policies of their children, in large part because they can't afford the co-pays and deductibles.
The language shifting co-pays and deductibles [from regional centers] to families was included in the budget trailer bill last year but should be removed now, said Marcia Eichelberger, president of the Autism Society of California.
Ironically, the money-saving move actually might be costing the state money, Eichelberger said, because the regional centers still need to treat the children who are being taken off private insurance. Centers have to pay the full cost of care if a child is moved from private coverage to Medi-Cal, Eichelberger said.
Kristin Jacobson, president of Autism Deserves Equal Coverage, said the survey shows the law requiring insurers to cover autism therapy -- SB 946 by Sen. Darrell Steinberg (D-Sacramento) -- is working. The problem, she said, is that the survey shows a high level of dissatisfaction that correlates with the percentage of people affected by the new co-pay/deductible rule.
"About 30% of them don't know about the law," she said. "It's great that 57% of those eligible are getting coverage, but that means 43% aren't getting approved, and the reasons for denial are inappropriate."