Antivax Woodstock in South Dakota

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.   And among those diseases could be COVID-19.

Antivaxxers are sometimes violent, often abusive, and always wrong. 

Tracy Connor at The Daily Beast:

An alternative medicine conference featuring notorious anti-vaxxers kicked off Friday in Sioux Falls, South Dakota, much to the dismay of local doctors and scientists. They’re worried the misinformation that will inevitably be spewed by the likes of Robert F. Kennedy Jr. could dissuade some in the state to reject the COVID-19 vaccine. The annual event is usually held in North Carolina, but organizers said they decided to move it this year to some place that “does NOT oppose our belief systems,” the Argus Leader reported. South Dakota Gov. Kristi Noem has encouraged residents to get vaccinated, but has opposed so-called vaccine passports.

Joe Sneve at The Argus Leader:

Among the featured speakers are Robert F. Kennedy, Jr. and Ty and Charlene Bollinger, three well-known vaccine skeptics who regularly share medical information that isn't vetted with evidence-based science with their social media followers and through various media forms, according to the Center for Countering Digital Hate.

A recent study by CCDH found the three were among 12 of the most prolific sources for medical misinformation regarding the COVID-19 pandemic.

 

Autism Mandate Fails in SD Committee

The Politics of Autism includes an extensive discussion of insurance.

At KELO-TV, Angela Kennecke reports:

For parents of children with autism, coverage for Applied Behavior Analysis was anything but guaranteed. In 2015, the South Dakota legislature passed a bill requiring insurance companies cover ABA therapy. But insurance companies have now discovered a loophole in the law that's allowing them to drop the coverage for many children with autism.

Here's the loophole: the 2015 South Dakota law does require Applied Behavior Analysis be covered for children with autism in large insurance pools made up of 50 people or more. But it did not require that those who are part of small groups or hold individual policies get the same coverage.

In Sioux Falls, KSFY-TV reports:

The House State Affairs committee Wednesday killed a bill that would mandate South Dakota health insurers include autism and spectrum disorders in their coverage.

SDBA reports the committee took 90 minutes of often emotional testimony late Wednesday afternoon before calling a 7-4 vote to send the bill to the 41st day, effectively killing the bill.

Supporters from across the state packed the Capitol building’s largest committee room sharing stories of the personal and financial impacts of caring for children with autism.

Opponents, including the South Dakota Division of Insurance and Sanford Health Plans, testified that the bill is a mandate and would require the State of South Dakota pick up as much as $1.4 million or more in costs.

As the vote was called, many of the supporters in the room broke down in tears.
KSFY News earlier this month spoke with two different Sioux Falls parents who were pushing for this insurance coverage.

Insurance Companies Applaud South Dakota Bill

AP reports on passage of a South Dakota insurance mandate that will benefit practically nobody, at least in the short run.

A group of lawmakers from both chambers ironed out a compromise Thursday that would require certain insurance plans to cover applied behavioral analysis therapy, which is not currently required of insurers in South Dakota but is in 38 other states.

Both the Senate and House passed the compromise version of the bill Thursday, sending it to Gov. Dennis Daugaard, whose administration supports it.

The bill requires coverage of ABA therapy only by providers who have a master’s or doctoral degree, which parents of autistic children say lessens its impact by limiting their options. But the legislation also establishes a workgroup of parents, lawmakers and insurers who will begin meeting this summer to figure out how to expand required coverage in the future.
...
Parents say the majority of the hands-on ABA therapy provided to children is from specialists who have high school degrees or higher, but not often master’s or doctoral degrees. They say limiting coverage doesn’t cover the majority of care given to children on a day-to-day basis. But insurers, who supported the version of the bill passed Thursday, had been worried about being required to provide coverage for workers who are not licensed to give care by the state.

The workgroup aims to establish a proposal for licensing and covering care providers not included in the bill passed Thursday.

Lobbyists for insurance companies applauded the compromise.

No kidding.  The bill is straight out of the Monty Python Insurance Sketch:

Vicar: But my car was hit by a lorry while standing in the garage and you refuse to pay my claim.

Devious: Oh well, Reverend Morrison, in your policy... in your policy... here we are. It states quite clearly that no claim you make will be paid.

Vicar: Oh dear.

Devious: You see, you unfortunately plumped for our 'Neverpay' policy, which, you know, if you never claim is very worthwhile, but you had to claim, and, well, there it is.

South Dakota Report

David Montgomery reports at the Argus Leader:

South Dakotans' health insurance costs would rise by as much as $2.50 per month if the state mandated coverage of an expensive but effective autism therapy many insurance plans won't pay for.

That's the conclusion of a report prepared for the Legislature by an outside consultant after passionate debate last year between parents and doctors touting the plan and insurance companies saying the therapy wasn't effective enough to justify the cost.

...
The report by Health Management Associates, released last week, concluded that insurance premiums would rise by 50 cents to $2.50 if ABA coverage were mandatory.

The report also found "moderate evidence" that ABA and similar treatments are effective. Children who receive ABA therapy while young "demonstrate improvements in language, cognitive, adaptive and ASD impairments" compared to a range of other treatments. The report found it was less clear whether ABA was effective among older children with autism.

Supporters of mandating ABA treatment said the report backs up their arguments.

A Forum in South Dakota

In Sioux Falls, SD, the Argus Leader reports on a public forum about insurance coverage.

Some spoke of their surprise to learn that Wellmark, the state’s biggest insurer, would be dropping its coverage of the ABA therapy. The therapy costs more than $100,000 a year.

“We’re a middle-class family. If you’re an autism family, you’re going broke fast,” said Richard Zeck, a Brookings resident whose 12-year-old son lives with the disorder.

Zeck said his family lived 11 years in North Dakota, where state policy mandated generous coverage of applied behavioral analysis, then moved to South Dakota, where there was no help.

“The difference is appalling,” he said of the two Dakotas.
...
Dr. Tim Gutschall, chief medical officer for Wellmark in Des Moines, then addressed the group. He listed several forms of less intense autism therapy that Wellmark covers, then told why Wellmark does not cover the ABA therapy.

Autism is not entirely a medical issue, but also an educational issue, and the ABA therapy has had inconsistent results, he said. He asked why coverage should be mandated when the science is changing so fast.

With that comment, Ron Larson, hurried back to the microphone to scold Gutschall.

“We’re not here to be lectured,” Larson said. When insurers such as Wellmark take a position on legislation, “they’re going to make money off it,” he added.

Movement in Georgia, Study in South Dakota

In Macon, Georgia, WMAZ-TV reports:

Medical marijuana is one step closer to becoming legal in Georgia, but it's taken a different form from its original version that passed the House 171-4 last week.

The Senate Health and Human Services committee unanimously approved House Bill 885 on Wednesday, which would legalize a form of medical marijuana in Georgia.

But the bill now also requires insurance companies to cover autism treatment for children ages 6 and under.

A few minutes before the vote, the committee's chairwoman, Renee Unterman, said the medical marijuana bill will be combined with the autism bill.

"We also combined the autism bill with it. We're calling it the Care for Kids Act," Unterman told 13WMAZ. "All the people in this legislature care about the children of Georgia."

AP reports:

The death of a bill to require insurers to cover autism inspired a South Dakota legislator to set up a task force on the issue.

"This came really hard and fast to me," said Rep. Scott Munsterman, R-Brookings. "Everyone agrees they needed to have that discussion whether (that bill) failed or not."

A South Dakota special committee of representatives and senators agreed Thursday on parameters for that study on autism spectrum disorders.

The task force would explore the issue and make policy suggestions. The study would cover insurance and treatment costs, availability of services and treatment protocols.

The state's human services and labor and regulation departments would collaborate on the project.

Representatives in the House and the Senate voted unanimously Thursday to accept the special committee's plan. Gov. Dennis Daugaard's administration has expressed support for the measure.

South Dakota Mandate Setback

The Sioux Falls Argus Leader reports that a South Dakota autism insurance mandate bill had a setback in a state senate committee:

Rep. Scott Munsterman’s bill sought to require some health care plans to cover ABA therapy and other autism treatments. From 60,000 to 90,000 citizens would be affected — primarily those who get their coverage from larger employers, and those with smaller plans that have been grandfathered in under the federal Affordable Care Act. Small business insurance plans and nongrandfathered plans on the marketplace would not be affected.

Munsterman originally proposed requiring all plans to cover ABA therapy. But under the Affordable Care Act, states that impose new coverage mandates on insurance companies are required to pay for that cost. To dodge a budget battle and weaken opposition from Gov. Dennis Daugaard, Munsterman narrowed the bill to apply only to those plans the state wouldn’t have to pay for.

But insurance companies said they shouldn’t have to pay for such expensive treatment, which they said would force them to pass costs on to customers in the form of higher premiums.

Wellmark previously estimated it might cost as much as $7 per member per year more to cover ABA treatment.

The Senate Commerce and Energy Committee voted 5-2 to kill the bill, with Sens. Ryan Maher and Angie Buhl O’Donnell opposed.

But supporters aren’t giving up. Munsterman is looking at ways to bypass the Senate committee, which could include sticking the autism language into another bill. That showdown probably will come on Monday.

Insurance Mandate Action in Georgia and South Dakota

The Atlantic Journal-Constitution reports:

Insurance companies would have to cover autism therapy for children 6 years and younger under a mandate passed Tuesday by the Georgia Senate.

Chamber leaders hailed the 51-0 vote for Senate Bill 397, which they said would provide some of the state’s youngest children the help they need to succeed later in life.

Business and insurance groups continue to oppose the effort, however, and warn it would increase health insurance premiums across Georgia.

Hundreds of advocates have spent at least five years pushing for autism insurance coverage, many of them inspired by a now 9-year-old Georgia girl named Ava Bullard. Ava is the great-niece of Sen. Tommie Williams, the chamber’s former president pro tem. She began applied behavioral therapy for autism at age 3 and now functions well.

SB 397, sponsored by Senate Insurance and Labor Chairman Tim Golden, R-Valdosta, does not go as far as many of the advocates would like, but most have celebrated it as a first step. Senate leaders, who fast-tracked the bill after weeks of behind-the-scene negotiations, have acknowledged it is a compromise that seeks to lessen complaints from opponents.

In South Dakota, the Rapid City Journal reports:

 Insurance providers should cover autism spectrum disorder in South Dakota, the state House of Representatives decided Monday.

House members voted 57-12 to send HB 1257 to the Senate for consideration.

“For seven dollars a year? That’s nothing. That’s peanuts. We blow that out of our gas tank driving around town every day,” Rep. Charlie Hoffman, R-Eureka, said.

The bill’s sponsor is Rep. Scott Munsterman, R-Brookings. He said a Wellmark witness testified the coverage would cost $2 to $7 per person annually.

“These kids are salvageable, and we want to save as many as we can,” said Rep. Scott Ecklund, R-Brandon, a medical doctor.

More than 30 states have autism mandates, according to Rep. Melissa Magstadt, R-Watertown. “We need this for our kids,” she said.

Only 25 to 35 percent of children with autism would be covered, said Rep. Mike Verchio, R-Hill City.

South Dakota Mandate Bill

In Sioux Fall, SD, KDLT-TV reports:

Children with cancer receive treatment, children with diabetes get insulin. So why is it becoming difficult for children with autism to get the help they need? That’s the question South Dakota State Representatives were faced with Thursday.

Several parents and therapists were in Pierre speaking with legislators about House Bill 1257. If passed as is, the measure will require insurance companies to cover all therapies for autistic individuals.

Robyn Stemper, mother of autistic child said, "A year ago, she would just bang her head on the wall and she would have a constant bruise on her forehead, we didn't go out much because it was just too overwhelming for her." 

Stemper's daughter Kierra was diagnosed with autism last December. Since then, the 5-year-old has been in Applied Behavioral Analysis, or ABA, 40 hours a week.

"They had her toilet trained within one to two months, she can sing songs, she can count to five," Stemper smiled. 

Stemper said in November, she received a letter from her insurance company saying they would no longer cover the ABA therapy, because they aren't required too.

"It's not based on her needs, it's based on money," Stemper said.