Yesterday, the House State Affairs Committee rejected HB 1236, a measure to revise certain provisions regarding health insurance coverage.
If you’ve been following the news, as this and another measure have been featured on most network news channels, the bill was to reverse a decision by state insurers to cease coverage for Applied Behavior Analysis (ABA) Therapy to treat children with Autism Spectrum Disorders.
It’s a battle that started several years ago in group plans, that culminated with a negotiated agreement for some very minimal extension coverages, and to set up a framework for the licensure of the therapists. This years’ fight was to attempt to extend the protections to all insurance plans. Naturally, the insurance carriers trotted out their same arguments against it, and the bill met the same fate as when the battle was first started several years back.
And like the first time the battle was fought, the mechanics of the regulatory structure for coverage, the laws and the “why’s” behind the measure are incredibly complex. Every time parents hope for a solution from lawmakers, it ends up going back to the drawing board for more education of lawmakers and elected officials as to why extending the coverage is the only solution that makes sense.
One of the arguments made by insurers is that by continuing the coverage they had provided would possibly raise insurance premiums some unknown figure between .30 to 2.50 a month to provide therapy that – in some cases – can eliminate nearly all limiting factors of Autism Spectrum Disorder. The therapy that people are seeking the ability to use their insurance coverage for over the course of a few years can allow these children who would otherwise qualify as disabled under state and federal law to be able to be educated, and to live, work, pay taxes, and contribute to society as you or I.
Now let you give you another figure on the other side of it.
As a parent of a child with Autism, my daughter is a bit of a tougher case. She requires a specialized program in her school environment right now, due to the severity of her disability under the laws which mandate that she’s provided a free and appropriate public education. She’ll probably always require the community supports that people with a disability are entitled to under state and federal law.
For a school district, depending on the level of their disability, kids with Autism can be some of the most challenging and expensive students that they work with. I know, as my daughter is one of them.
As a student, my daughter costs the Brookings School District somewhere in the neighborhood of $10,000-12,000 a month. And that’s every month, year-round, as her disability requires summer services. For one student, she’s over $100,000 a year. And she’s not the only student in the Brookings School District with Autism, as her program has other kids who attend.
And that’s just ONE school district.
The expense for providing services to children with disabilities who aren’t successful in a regular classroom environment can be considered one factor in high-dollar special education budgets, as the state is hitting crisis mode with the extraordinary cost fund.
That additional $100,000+ my daughter’s education costs are the expenses to taxpayers while she’s in school. As a person with a disability, we haven’t even ventured a guess as to what her lifetime expenses will be in serving her support needs in an independent apartment, if she’s ever able to live independently. Over her lifetime, it will total in the millions to taxpayers through services rendered through DHS and DSS.
And again, she’s not the only one with Autism in the state.
These issues don’t exist on their own silos. Legislators can help address a facet of the problems we have with special education costs by helping parents who want to help their kids. Steps today can help with future expenses in the budget for DHS or DSS in the future.
These are real and tremendous costs to South Dakota taxpayers. When lawmakers resisted a request from families begging for the ability to access their own insurance coverage to pay for proven therapies that turn many kids who would be an expense to taxpayers into contributing taxpayers themselves, it was a missed opportunity.
It’s what our grandmothers spoke about when they used the phrase “an ounce of prevention..”
With a little initiative, lawmakers still have the opportunity to save millions of taxpayer dollars in the long run. I can assure you that the parents who testified yesterday are very interested in doing so and they will continue to fight for a chance for their kids to have a life just like you or I.
We don’t need a study, as we’ve already done that. We don’t need to prove that ABA therapy works, as that’s proved by studies and evidence. Parents just need the chance that they’re asking for.
Legislators still have time and the opportunity to make it right this session, if they choose to take it.