29 Nov

Bill to mandate insurance coverage for autism has a chance in lame duck, says Lt. Gov. Brian Calley

Published: Monday, November 29, 2010, 4:01 PM     Updated: Monday, November 29, 2010, 6:49 PM

Sue Thoms | The Grand Rapids Press Sue Thoms | The Grand Rapids Press

Lt. Gov.-elect Brian Calley will make a last-minute push Tuesday to require insurers to cover autism treatments when he urges the Senate Republican caucus to put the legislation to a vote.

Calley, whose daughter has autism, says the insurance reform bills will save the state $14 billion — as well as improve the lives of the 15,000 Michigan children who have autism.

State Rep. Calley, R-Portland, who represents portions of Ionia and Barry counties, said he is optimistic the legislation will be passed before the Senate adjourns Thursday.

“I know it has the votes to pass (in the Senate),” he said. “I am sure of that. The only way to stop it is to not allow it to go to a vote.”

Although his experience with his 4-year-old daughter, Reagan, gives him a strong personal stake in the issue, Calley said he supported autism insurance reform long before his daughter was diagnosed. The bills mandating coverage for autism diagnosis and treatment passed the House in June 2009.

“The economics behind this are so powerful,” he said.

Services covered under the legislation include occupational, speech and sensory integration therapy. The most controversial service is applied behavioral analysis, an intensive drill-based therapy that is conducted five to six hours a day.

Though expensive, the therapy can help some people with autism “be cured of all symptoms,” Calley said. For many people, it can make the difference between a lifetime of dependency and one with a career and independent income, he said.

Calley said studies show the reform measures would increase rates by less than 1 percent.

That argument is not convincing to the Grand Rapids Area Chamber of Commerce, which opposes the legislation.

“Government at all levels should not mandate participant benefits in employer-sponsored plans,” said Andy Johnston, the chamber’s director of legislative affairs. The legislation would primarily affect small employers; large employers with self-funded plans would not be obligated to provide it, he added.

“It would increase the cost of insurance at a time when small employers can ill afford it,” Johnston said.

Calley said the exclusion of autism from health insurance policies reflects an outdated view of autism – that it is not curable and that autistic people should be institutionalized and isolated.

“It’s an outdated thing, and it’s an excuse at this point,” he said.

Even services provided to children with other conditions – such as speech therapy and sensory integration therapy – are not covered if the child has been diagnosed with autism.

Coverage for autism is mandated in 23 states. The lack of coverage in Michigan diminishes the availability of care, even for those who can afford to pay out-of-pocket, Calley said.

The state has 60 therapists trained in applied behavioral analysis but needs 2,000 to cover all the children who have autism, he said.

Calley said his daughter was diagnosed with autism when she was 2 years, 9 months old, and it took him six months to come to terms with it.

“Our society has taught us to be embarrassed about this,” he said. “I decided I’m not going to. If I can speak up and have the type of profile where people are going to pay attention to that, then I just have to do it.”

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