Tea Party. v. Virginia Mandate

Anita Kumar writes in The Washington Post:

The Virginia Tea Party Patriot Federation, the umbrella group of tea party organizations in the state, has come out against a bill backed by House Speaker Bill Howell that would require businesses to provide insurance coverage for children with autism.

"Autism is certainly a heartbreaking condition and the treatments are a terrible financial strain for many families,'' said Mark Kevin Lloyd, chairman of the Virginia Tea Party Patriots Federation.

"The concern of the Virginia Tea Party Patriot Federation with this bill is the inappropriate use of government," Lloyd said. "There is nothing stopping individual insurance companies from adding this coverage themselves as part of free market competition. Virginia, and our nation, has a history of private individuals and groups assisting those who are in unfortunate circumstances. Government is not an arm of compassion, and no matter how well intended, can never replace faith-based and private initiatives."

Howell's position, which all but ensures the bill will pass the General Assembly this year, has upset some members of his caucus, who question supporting a new mandate while opposing the health care overhaul passed last year. Americans for Prosperity, a conservative group that opposes the federal health care overhaul, began robocalls statewide Monday targeting Howell (R-Stafford) that will run through Wednesday's House vote.

Proponents of the bill are pushing back, according to the Richmond Times-Dispatch:

A conservative group, Americans for Prosperity, began making automated calls opposing the legislation this week.

Del. Robert G. Marshall, R-Prince William, one of the House's most conservative members, called that an "attempt to manipulate the public," saying the measure does not mandate the purchase of health care, but rather defines the content.

An attempt by Del. Benjamin L. Cline, R-Rockbridge, to amend the bill to say that employers must offer a package that includes autism coverage, but not provide that package to each employee, was shot down.

See Del. Tag Greason introducing the bill:

Mandate Advances in Virginia House

The Roanoke Times reports:

Advocates for autistic children moved one step closer to a long-sought legislative victory Tuesday, as the House of Delegates advanced legislation requiring some employee insurance plans to provide limited coverage for early intervention services.

The House advanced the bill on a voice vote after supporters thwarted an effort to weaken the measure. Republican backers also pushed back at conservative critics who have charged them with hypocrisy for backing a state insurance mandate while opposing the massive federal health care overhaul.

"It is the most restrictive autism bill in the country, but it will help hundreds of families that desperately need our assistance," said Del. Thomas "Tag" Greason, R-Loudoun County, the bill’s sponsor.

...

Del. Bob Marshall, R-Prince William County, said "there is no essential contradiction" in supporting the autism coverage mandate and opposing the federal health care law. Marshall last year sponsored legislation designed to protect Virginians from being required to purchase health insurance. He also has sponsored bills to require insurers to provide autism coverage.

"We’re not mandating that you purchase insurance, but that if the insurance is purchased, it must come in a particular form or shape or type," Marshall said.

Marshall may have been responding to a Washington Times editorial titled "Obamacare, Jr.":

Bizarrely, it’s the GOP leading the charge to expand the government’s role in the Old Dominion. By a 16-6 vote last week, a House of Delegates committee approved a measure that would compel insurance companies to provide up to $35,000 worth of annual coverage for the treatment of children diagnosed with autism. The measure has the strong backing of House Speaker William J. Howell, a Republican who apparently enjoys passing legislation that “does something” about some sort of terrible affliction - as long as he is spending someone else’s money.

The problem isn’t so much that the autism bill would drive up the already high cost of insurance for everyone; a state analysis showed more sweeping coverage would have cost an extra $59 per year. Rather, the issue is the cumulative effect of all the coverage mandates in Virginia and around the country. According to the Council for Affordable Health Insurance, Virginia’s 57 separate insurance policy requirements place it at No. 5 on the list of most-regulated states. Maryland, one of the four with a higher chart position, already has autism coverage. It also forces insurance companies to pick up the $100,000 tab for in vitro fertilization treatment and subsidize contraceptives and nicotine patches. Maryland even forces companies to include homosexual “domestic partners” on policies. Taken together, these schemes drove up the cost of an individual insurance policy by 19 percent, according to a 2008 study by the Maryland Health Care Commission.

Americans for Prosperity v. VA Autism Mandate

Anita Kumar writes in The Washington Post:

Americans for Prosperity, a conservative group that opposes the federal health care overhaul, began robocalls statewide Monday targeting Bill Howell, the powerful speaker of the House of Delegates, for his support of a bill to provide insurance coverage for children with autism.

The calls to the group's 80,000 Virginia members began Monday afternoon and will run through this week's House vote.

"To rail against the mandates in Obamacare then turn around and support mandates in the state level is nothing short of hypocrisy,'' said Ben Marchi, the group's state director.

As we reported earlier, Howell (R) has put his considerable weight behind the bill that would require businesses to provide insurance coverage for children with autism after failing to support similar proposals in past years.

FactCheck.org provides background on the group:

Americans for Prosperity was founded by David H. Koch of Koch Industries. Koch and his wife, Julia, are major GOP contributors: They have donated more than $2 million to federal candidates and party organizations since 1990, according to the nonpartisan Center for Responsive Politics. Koch also ran for vice president on the Libertarian Party ticket in 1980, and currently serves on the board of the Cato Institute, a libertarian think tank, according to his biography on the AFP website.

The group’s president is Tim Phillips, a Republican campaign strategist who helped organize tea party protests. Directors of the organization include Art Pope, a former North Carolina congressman, and James Miller, former chairman of the Federal Trade Commission and budget director under President Ronald Reagan.

AFP is registered under the IRS code as a 501(c)(4) — meaning it does not have to disclose its donors. The Wall Street Journal said "some of the group’s funding comes from" Koch. Donations to the group are not tax-deductible.

Offit on Colbert

Lisa Jo Rudy reports:

Dr. Paul Offit is an immunologist whose books, articles and media appearances have placed him at the center of the autism-vaccine controversy. Offit has argued for years that vaccines have no relationship to the rise in autism spectrum diagnoses, and his point of view has earned him avid supporters as well as death threats. On Monday night, he will appear on Stephen Colbert's tongue-in-cheek "news" comedy, The Colbert Report to speak about his new book, "Deadly Choices: How The Anti-Vaccine Movement Threatens Us All". The show will air on Comedy Central, January 31st at 11:30 EST (the interview will take place toward the end of the program).

One can guess at how the program will go from Colbert's June interview with Michael Specter, author of "Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens Our Lives,"

The Colbert Report	Mon - Thurs 11:30pm / 10:30c
Michael Specter
www.colbertnation.com
Colbert Report Full Episodes Political Humor & Satire Blog</a> Video Archive

Spillovers

Policy decisions involving broader issues have a distinct impact on the autism community. Here are cases in point.

The Washington Post reports:

An expert panel advising the Food and Drug Administration decided Friday that electroconvulsive therapy (ECT) machines should undergo the same rigorous testing as new medical devices coming onto the market - a decision that could drastically affect the future of psychiatry's most controversial treatment.

The majority of the 18-member committee said not enough is known about ECT, also known as "electroshock" or simply "shock" therapy, to allow the devices to be used without more research into its usefulness and hazards.

...

About 100,000 Americans undergo ECT each year, usually getting about a dozen treatments over several weeks. Some then get "maintenance" ECT every few weeks, as the therapeutic effect, when it occurs, often doesn't last. The treatment is most often used for depression and has also been prescribed to patients with schizophrenia, catatonia, and more recently, to some violent children with autism.

Kevin Sack writes in The New York Times:

Hamstrung by federal prohibitions against lowering Medicaid eligibility, governors from both parties are exercising their remaining options in proposing bone-deep cuts to the program during the fourth consecutive year of brutal economic conditions.

Gov. Andrew Cuomo of New York is expected to propose at least $2 billion in cuts in his budget.

Because states confront budget gaps estimated at $125 billion, few essential services — schools, roads, parks — are likely to escape the ax. But the election of tough-minded governors, the evaporation of federal aid, the relentless growth of Medicaid rolls and the exhaustion of alternatives have made the program, which primarily covers low-income children and disabled adults, an outsize target.

TV Story on Virginia Autism Bill

WTKR reports:

Autism and Insurance in Oklahoma

The Edmund [OK] Sun reports:

Nick’s Law would have provided insurance coverage for the early diagnosis testing of autism and medications until the child becomes 21 years of age. A financial cap would have covered $50,000 of behavioral therapy per year without lifetime caps in the House plan.

State Rep. Mike Brown, D-Tahlequah, has filed HB 1624 to bring Nick’s Law to a vote of the people. With a large favorable response from a SoonerPoll last year showing 79.5 percent of all Oklahomans favoring passing of this measure.

A state actuarial report determined that Nick’s Law could raise insurance premiums from 7.8 percent to 19.8 percent.

In 2007, the Council for Affordable Health Insurance, a research and advocacy association of insurance carriers, reported insurance mandates regarding autism will have little impact on the cost of health insurance premiums for consumers. The report assessed the incremental cost of state-mandated benefits for autism in 10 states would be less than 1 percent.

The Oklahoma State Education Employees Group Insurance Board announced its own study revealed that Nick’s law would have 1 percent or less impact on claims.

The Edmund [OK] Sun also reports on another measure:

State Rep. Randy Grau, R-Edmond, has introduced coverage for autism and related disorders through the state’s high risk insurance pool.

“There’s been talk for years about trying to mandate coverage for private insurance and I think this is the best solution because it will give families one place to come where they can get coverage for their children,” Grau said.

The High Risk Pool was created by the Legislature in 1995 to serve those who have been denied health insurance due to a serious health condition.

Grau and his wife have been friends with Eric Littleton’s family for several years, having worshiped together at church. One of Eric’s twin 7-year-old sons contracted Landau-Kleffner syndrome in 2008.

...

State Rep. Jason Murphey, R-Guthrie, said he would need to study the specifics of HB 1248 before supporting it.

Murphey said he was an avid supporter last year of a bill by state Rep. Jason Nelson, R-Oklahoma City, that was signed into law. Murphey said HB 3393 allows families to receive assistance they need through a school choice voucher program.

“Since so much of the treatment is behavioral and not so much medical I feel this is a great approach,” Murphey said.

Littleton said HB 3393 is well intentioned but he has not found a school in Oklahoma County that is willing to accept Solomon with HB 3393.

“Getting that expanded would help,” he said.

See earlier post on HB 3393

Virginia Insurance Mandate Advances

The Richmond Times-Dispatch reports:

With the powerful backing of Speaker of the House William J. Howell, R-Stafford, a bill to mandate coverage of autism disorders passed Thursday in a House of Delegates committee that had killed it in previous sessions.

The bill was limited to apply to children from ages 2 to 6, to cap annual costs at $35,000 and to apply to businesses that employ more than 50 people and are not self-insured. It also covers public employees.

Passage by the House Commerce and Labor Committee, on a 15-6 vote, virtually assures its passage in the General Assembly session, because the pro-business committee has blocked it in recent sessions. Another bill is pending in the Virginia Senate, but the Senate has always favored the mandated benefit.

"We have never gotten out of committee in the House of Delegates," said John W. Maloney of Henrico County, an advocate whose 15-year-old son has autism. "It's really exciting."

Consequences of Cuts

The Spartanburg Herald Journal reports on service cuts in South Carolina:

Tammy Gilbert might have to make a choice no parent should: Does the Spartanburg mother give up her child or does she quit working so she can take care of her daughter?

State budget cuts to Medicaid and other programs are forcing those kinds of choices on Gilbert and, she said, thousands of other South Carolina families. Gilbert's daughter, Paige Lynn Taylor, has autism, mental retardation and cerebral palsy.

“I am here to ask you to protect her as the 7-year-old her mind is, not the 21-year-old her body is,” Gilbert said Wednesday before the House Ways and Means Subcommittee on Health and Human Services.

...

More than 120 children and adults with mental or physical disabilities sat before the House subcommittee Wednesday. McCarthy Teszler School Principal Cheryl Revels, who has two special-needs children of her own, and Charles Lea Center Executive Director Jerry Bernard also testified, saying services that directly affect the lives of people with disabilities are, in fact, essential.

“In the long run, we are not saving money,” Revels said. “The children are not going to have the opportunity to develop skills necessary to be independent individuals of society. And we will be paying for them down the road.”

Revels pleaded with the four legislators in front of her — state Reps. Brian White, Harry Ott and Bill Herbkersman of the subcommittee, and Rep. Harold Mitchell of Spartanburg. Mitchell helped arrange the visit.

“It's real good for my colleagues to see the faces of the cuts that they're making,” Mitchell said in an interview.

...

“One of our biggest challenges, with the budget, with all the demands we have and the mandates, is taking care of the vulnerable folks that we have,” said White, an Anderson Republican and subcommittee chairman. “I don't think it's the intention of anybody to not fill that need. It is truly a need, and they are blessed children. They are God's creation, and we need to take care of them.”

About 31,000 South Carolinians depend on Medicaid and the Department of Disabilities and Special Needs, Revels said.

More on autism and Medicaid here.

Autism Speaks Backs CA Insurance Bill

A press release from Autism Speaks:

Assembly Bill 171 Would End Health Care Discrimination Against Children with Autism by Requiring Coverage of Diagnosis and Treatment

NEW YORK, NY (January 25, 2011) – Autism Speaks joined today with members of the Alliance of California Autism Organizations (ACAO), families and other autism advocates to announce its support for Assembly Bill 171, the autism insurance reform bill. The legislation would require private health insurance companies to cover the screening, diagnosis, testing, and treatment of individuals with autism spectrum disorder (ASD).

Sponsored in the California State Assembly by State Assembly Member Jim Beall Jr., AB 171 includes coverage of behavioral health treatments, such as Applied Behavior Analysis (ABA), an evidence-based, medically-necessary autism therapy. The bill contains no caps on age, number of visits to a service provider, or annual dollar maximum.

“We applaud and thank Assembly Member Beall for his leadership on this issue of critical concern to thousands of California families,” said Peter Bell, Autism Speaks executive vice president for programs and services. “Autism Speaks is thrilled to work in unison with California’s autism community at large through the Alliance of California Autism Organizations in calling on the legislature to pass AB 171 and join the growing number of states that have ended healthcare discrimination against children with autism.”

Many states do not require private insurance companies to cover even essential autism treatments and services. In the absence of coverage, families often pay as much as they can out-of-pocket for services that can cost upwards of $50,000 per year. In the process, many risk their homes and the educations of their unaffected children – essentially mortgaging their entire futures.

“After so many years of work on autism insurance reform legislation as part of a united autism community in California, it is exciting to finally see this legislation move forward,” said Kristin Jacobson, Autism Speaks California Chapter Advocacy Chair. “It is an honor to work with the Alliance of California Autism Organizations to help bring about an end to health insurance discrimination against individuals with autism. As an advocate that has worked with so many families struggling to get insurance coverage for treatment, I know that this bill will help thousands of families like these across the state.”

To date, twenty-three states – Arizona, Colorado, Connecticut, Florida, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, Pennsylvania, South Carolina, Texas, Vermont, and Wisconsin – have enacted autism insurance reform legislation. Several other state legislatures will introduce similar legislation during the current 2011 session.

A Cartoon Expresses Parent Frustrations with Special Ed

California Cuts, Continued

See earlier posts about California budget cuts affecting people on the spectrum: here and here

The Arc is calling for action:

The Arc and other disability organizations are fighting in the Capitol to protect our community’s services. To limit the damage, we need a strong show of support from the community. That means you and the people you know throughout the state.

I’ll tell you more about the threat, but first, here’s what I’m asking you to do:

· Come to Sacramento on Thursday, February 3, and Thursday, February 10, the dates of the Legislature’s only public hearings on the developmental services budget. We need to fill the hearing rooms with people who are ready to tell the legislators what the real effect of the earlier cuts has been and what the likely categorical reductions and service eliminations would mean to them and the ones they love.

· Call your local state senator and assemblymember this week and give them the same message.

The threat is caused by the state’s massive budget shortfall, probably the worst since the Great Depression. To balance the budget, Governor Brown has proposed more than $12 billion in cuts and about the same amount in revenue increases by continuing some existing taxes by five years.

In developmental services, that would mean cuts to services of more than three quarters of a billion dollars—real, new cuts, over and above continuing the much smaller 2009 and 2010 cuts. The total cut this year would include the federal matching funds we would lose as a result of the state fund cuts.

It’s hard to grasp how much a cut that large would reduce the Lanterman Act services, especially because the governor hasn’t said exactly where the ax would fall. The state could eliminate all the regional centers’ operating budgets and still not cut that much.

We do know that most of the cuts probably would come from imposing what are called statewide “service standards.”

“Service standards” sounds good, doesn’t it? But what it means is simply eliminating the IPP team’s ability to pick the services and supports that the person with the disability needs, the key promise of the Lanterman Act. The 2009 caps on respite care and Early Start are the most recent examples of “service standards.”

Under the Lanterman Act, IPP teams write plans to reflect the specific needs of individuals, but with the cuts being proposed this process would certainly be harmed dramatically. Let the policymakers know how the services and supports benefit you and the real consequences to your life and the lives of your family members.

Real life consequences to real life people throughout the state are the kinds of things you should communicate to the legislative committees in Sacramento and to your local state senator and assemblymember. Tell them the cut is just too big to bear.

Here is the best information I have as of today on the committees’ public hearings:

· Assembly Budget Subcommittee on Health and Human Services, 9:30 a.m. or later, February 3, Room 4202, State Capitol, Sacramento.
· Senate Budget Subcommittee on Health and Human Services, 9:30 a.m. or later, February 10, Room 4203, State Capitol, Sacramento.

Non-Inclusive Inclusion

Lisa Jo Rudy writes that "inclusion" programs are a fine idea, but...

All too often, though, community programs for people with autism are simply dead ends. They don't provide a stepping stone or scaffolding to help the child, teen or family with autism build the skills to join the general community. Families can take part in these special programs, or not. But there's no support for or interest in taking the next step - or even in creating programs to support families with older or adult children on the autism spectrum.

I just got off the phone with a representative of a music education program for children with autism - a wonderful idea, in theory. She seemed offended, however, when I asked whether autistic music students perform at recitals with typical music students. She seemed very uncomfortable with the thought that her instructors might facilitate inclusion of autistic music students in typical school bands. Every aspect of the music program is, apparently, hermetically sealed off from the rest of the world.

I've seen many sports programs available only to young children with autism. These programs, run by well-meaning adults, are specifically geared to teaching social skills rather than sports skills. There's no interaction between the "special" and the "typical" youth sports directors. As a result, when the children age out of such programs they're no more able to play a typical sport than they were before they started. And now, as they begin to enter their teen years, they have no place to go.