Proponents become opponents on autism bill

[Guest guest]

Proponents become opponents on autism bill

By DAVE PIDGEON, Bird's-Eye View

http://articles.lancasteronline.com/local/4/223800

Private insurance companies will continue denying coverage of autism

treatments under a bill passed 49-1 by the state Senate on Sunday,

opponents said prior to the vote.

The opponents originally stood as proponents of a mandate forcing

private coverage, but the final version of the bill was so amended,

they said, the proposed mandate would actually hurt families dealing

with autism.

The original version — authored by state House Speaker Dennis O'Brien,

who slammed the final Senate revisions prior to its passage Sunday —

would have forced insurance companies to cover autism treatments up to

$36,000, with the state's Medical Assistance program helping families

with any costs above the cap.

A report commissioned by the Pennsylvania Health Care Cost Containment

Council said last week that the original mandate would end up costing

all insurance customers about $1 per month.

The Senate Banking & Insurance Committee, however, amended the bill

last week. According to O'Brien and others who once supported the

bill, the revisions passed Sunday by the Senate allow insurance

companies to decide for themselves what services to cover.

While the bill sets up a system to challenge any denial, disappointed

former supporters said the bill now makes affording vital but

expensive treatments prohibitive.

" When insurers deny coverage, families will have no alternative but to

reach into their own pockets to pay for the medical treatment, "

Estelle Richman, a one-time supporter and secretary of the Department

of Public Welfare, wrote in a letter Sunday to Republican Sen. Don

White, a former insurance broker and chairman of the Banking &

Insurance Committee. " This means they will be worse off ... . "

O'Brien, who has placed much of his legacy as a legislator into

getting this mandate passed, called the bill an " illusion " of

insurance coverage for autistic children.

" That's because the current version gives the insurance companies a

back-door way to continue denying coverage for autism services, " he

wrote in a statement. " Insurance companies will continue to

second-guess these kids' doctors and refuse to pay for autism

services. The Senate-amended version gives them the power to

unilaterally deny that coverage ... . "

Also rejecting the new bill were AutismLink and the Autism Center of

Pittsburgh, but the national organization Autism Speaks announced its

support of the current version as did Sen. Jane Orie, co-chair of the

Autism Caucus.

" The bill now moving forward, if signed into law, would be the

strongest autism insurance mandate yet achieved in the nation, " said

Emken, vice president of government relations for Autism Speaks.

Supporters also trumpet other amendments to the bill, including

government oversight of a pending merger of two large Pennsylvania

insurance companies — Highmark and Independence Blue Cross — and

insurance coverage of colorectal cancer screenings.