Big story in Cap Journal about the passage of HB 1257 to cover autism treatment, and to help reduce a 6 Billion cost to taxpayers.

The Pierre Capitol Journal has a big story today on the passage of House Bill 1257 to cover the treatment of autism with ABA or Applied Behavioral Analysis therapy.

It might not seem like a big measure to many, but for the parents of kids with autism (disclaimer, including myself, and I’m active on the measure), it’s been a long time in coming to make South Dakota join the rest of the country on this:

The House of Representatives approved HB 1257 on a 57-12 vote. The bill, which was sponsored by the House Committee on Health and Human Services, would require insurance companies in the state to cover applied behavior analysis, or ABA, therapy.

According to the Centers for Disease Control and Prevention, 1 in 88 children in the United States has been identified with a form of autism. The CDC says ABA therapy is widely accepted among health care professionals.

With early diagnosis and ABA therapy, children diagnosed with autism can often be mainstreamed into regular education classes.

Christian Stanley, 5, hopes to be one of those mainstreamed children. Christian was diagnosed with autism shortly before turning 4. After his diagnosis, Christian began to spend 35 to 40 hours a week with a therapist while at home and school. The therapy has allowed Christian to interact with children his own age – something which was difficult before he began therapy.

and…

Several members of the House voiced support for the bill on Monday. Rep. Ecklund, R-Brandon, said 47 percent of children who receive ABA treatment are mainstreamed by the time they reach middle school. Ecklund said the cost of a child that goes untreated for autism could be as high as $3.2 million during a child’s lifetime.

and..

According to the American Speech-Language-Hearing Association, 34 states have enacted autism insurance laws that would require coverage for the diagnosis and treatment of autism, which would include ABA therapy.

Read it all here.

The reality of it is, aside from being a pro-family measure, as it affects 1 in every 88 kids, it’s a pro-taxpayer measure.

There are over 1900 people identified in South Dakota as being affected by autism. Take that times $3.2 million average cost (and the article gets it wrong, it’s $3.2 M average, not high).  That’s a cost to taxpayers of $6.08 BILLION with a B over the lifespan of the affected children. If we can reduce that cost for taxpayers in half or more, we owe it to ourselves to give them a chance.

A facebook group advocating Autism Insurance Reform in South Dakota has been started at https://www.facebook.com/groups/pairsd/.

If Autism has touched you, a family member, or a friend, feel free to check it out, and join.

7 Replies to “Big story in Cap Journal about the passage of HB 1257 to cover autism treatment, and to help reduce a 6 Billion cost to taxpayers.”

  1. Rep . Mike Verchio

    As the grandparent of a child with Autism I had to swallow hard when I voted against this bill . When we only cover 1/3 of those who need this coverage with no criteria on who gets covered it smacks of Big Brother picking winners & LOSERS . Another fact is that Avera does offer the coverage . The free market system works .

    Reply
  2. Rep . Mike Verchio

    As the grand parent of a child with Autism I had to swallow hard when I voted no on this bill . By covering only 1/3 of those in need with no criteria on who receives the coverage it smacks of Big Brother to me . Who picks the winners and LOSERS ? Avera offers this coverage right now , today . The free market has already solved the problem .

    Reply
    1. sdsen_2014 Post author

      Mike, go tell the parents of your grandchild to “just change insurance,” and see what they say. It’s not that simple.

      I had coverage through a company (Wellmark) who covered it. Then, they up and dropped it in the middle of the year, solely because the mandate is not in South Dakota, as it is in 34 other states.

      The net effect? They saved the .31 cents a month the coverage costs. I haven’t seen a reduction in premium, but I have a massive increase in costs personally.

      What am I supposed to do to change insurers? Tell my wife to quit her job, and leave the state?

      As I noted in the FAQ’s I sent legislators:

      Many families insurance coverage is provided through their employer plans. Moving to another insurance plan just simply is not an option for most families. For example, I am self-employed and my wife’s employer provides our insurance. We cannot take the dollars we spend on that employer provided insurance and go somewhere else to purchase a different insurance. She would have to quit her job in order to move my family to a different plan. Many people are forced to do that, or in some cases leave South Dakota to find jobs in one of the many states that provide the mandate.

      In addition, no one provides specific ‘autism insurance.’ Most insurers in the health market offer coverage for mental health benefits but again, the problems arise in how insurers consider autism spectrum disorders and how they approach coverage. Again, a consistency problem exists. This bill would help with the issue of consistency.

      The marketplace solution in this case is a myth, because unlike diabetes, or other wide-ranging health conditions, the numbers in our state are too small to affect the marketplace.

      Reply
    2. A grandparent

      Does your Autistic grandchild live in SD
      Shame on you for voting against the bill.
      Swallowing hard wont help other grandparents in Sd who have Autistic grandchildren.

      Reply
    1. sdsen_2014 Post author

      Not really, because guess what? Obamacare left it out too. Even if a person wanted, the Essential Health Benefits under Obamacare were supposed to cover treatment of autism, but in the final form, they failed to include it as promised.

      Reply
  3. A grandparent

    Does your Autistic grandchild live in SD
    Shame on you for voting against the bill.
    Swallowing hard wont help other grandparents in Sd who have Autistic grandchildren.

    Reply

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