When President Obama and Democrats pass a law forcing insurance companies to cover individuals and procedures that they don't consider profitable, Republicans cry bloody constitutional and economic murder. When Republicans pass a law forcing insurance companies to cover individuals and procedures that they don't consider profitable, it's a great day in South Dakota.
Republican blogger Pat Powers rejoices over the South Dakota House's approval of House Bill 1257, a bill to require health plans to cover "screening, diagnosis, and treatment of autism spectrum disorder." "It's been a long time in coming," says Powers, who is the parent of a child with autism. Powers says HB 1257 is pro-family and pro-taxpayer, since it transfers $3.2 million in average lifetime costs of caring for each autistic child from society's shoulders to insurance companies (which get their money from policyholders, who are members of society...).
The wicked Affordable Care Act forced insurers to stop excluding children with autism and to cover autism screenings. But it left states the authority to define the "essential benefits" that insurers must cover. HB 1257 avoids calling applied behavior analysis, the main autism therapy under discussion, an "essential benefit," thus sparing the state from having to pick up any costs.
An insurance lobbyist noted that Medicare and Medicaid don't cover applied behavior analysis. HB 1257 goes farther than the wicked federal government in controlling the health care marketplace.
But no matter. When we strip away abstract, arcane arguments about political philosophy, when we put real faces, real children, real families, and real medical needs on the front page, the health care debate becomes very different. Ask a parent with an autistic child if laws to help that child get medical help without bankrupting the family is a good idea, and that parent suddenly becomes a big-government liberal... which is fine with me.
Interesting what Pat Powers rejoices on. I do have nothing against insurance companies covering autism or for that matter, all things that involve heath issues. What I find interesting is that as a republican, Powers speaks clearly on why insurance policies would never be able to sell across state lines because of the different sets of rules allowed by individual states. What may be great for Powers and South Dakota, may not be seen that way in Nebraska. The good news is that Mr. Powers and the rest of the republicans could join democrats in setting the stage for true complete coverage, universal health care coverage for all. Que the screams of bloody mayhem.
I always have to giggle about the hypocrisy of folks who think government programs benefiting other people are bad or socialistic, or un-American, but at the same time think that any government program that benefits them personally is just awesome.
As the grandparent of an Autistic child I had to swallow hard when I voted against this bill . Why would we only cover 1/3 of those who need this coverage with no criteria on who receives the coverage . Smacks of Big Brother to me . Who picks the winners & LOSERS . Avera already offers this coverage . The free market works . It's fixed without government interference .
Rep. Verchio, help us understand more about your nay on HB 1257. Who are the 2/3 in need being left out by HB 1257?
Seems to me a basic wingnut gripe about forcing coverage is the cost will be passed on to the consumer,resulting in higher costs. Isn't that a basic truism of free markets? Let the markets decide winners and losers by who can afford to pay.
You have answered your own question Mr. Verchio, why should we only cover 1/3 of those who need it. You have a position of power to make a difference not only in your grandchild, but for all. Why don't you stand and deliver on a promise that makes it simple for all to have access to the healthcare that is not from Big Brother, but from the Big Heart of America. All of our people need to be secure from the fear of not having the safety net in any event. Consider Medicare and you can see that government and private markets can work together to protect and serve the over 65 crowd and our disabled, why not apply it to all?
my own opinion is that Autism shouldn't be treated medically. As much as the parents and grandparents would like to pop pills into the kids and make them all better, it doesn't work that way. I recall hearing Temple Grandin speaking on how she feels fortunate to have grown up in an era when autistic children were treated by educational methods. It was all in the training. She had to go to church, sit down and be quiet. No excuses because she was autistic, and she learned to behave herself. So I can see why health insurance companies might object to paying for medical treatment, and it bothers me to think that if medical treatment is paid for by a third party, then that will be the first course of action applied. If the medical treatment is the primary one, educational interventions which might help the child function in society will fall by the wayside. I just see unintended consequences of this all over the place.
Everyone is entitled to their own opinions Anne Beal. I think that the doctors happen to know best though. http://www.webmd.com/brain/autism/autism-treatment-overview
Health insurance needs to cover this as it is a treatable condition, simple as that. For those that reject that, you are passing an unnecessary burden onto already stressed families.
Anne - Mental healthcare - or Behavioral healthcare - are required to be covered under the ACA. This is not just pushing pills.
It’s amazing what “Big Brother” has done to advance the research in children with Autism. Because of the “Big Brother Genome Project” in the 1990’s, we have discovered several mutations in the FAN1, a gene in the 15q13.3 chromosomal region, which raises the risk of neuropsychiatric disorders including autism, according to a new study published 7 January in the Proceedings of the National Academy of Sciences1.
Now, President Obama has another Big Brother Brain Research through Advancing Neurotechnologies (BRAIN) Initiative, a Grand Challenge designed to revolutionize our understanding of the human brain. Just as the Genome Project has done to save health care dollars and improve lives, the BRAIN Initiative could also lead to improvements in our ability to diagnose, treat, and even prevent diseases of the brain, including Autism.
Anne, do we really want to treat mental illness based on anecdotal stories and evidence or do you think we should let scientists and physicians handle this? (With apologies to the entertainer Dr. Oz.)
Oh and Mike Verichio...tell us again about this free market health care economy. You know, the one that is recording record profits under the burdensome yoke of Obamacare.
Tell us how your free market vote on Medicaid expansion is the best thing for our rural healthcare. Oops, did I bring up how your decision will cripple rural healthcare....sorry, my bad. Carry on.
Dr. Kevin—aaaaccck! What's government trying to do, researching diseases, promoting science, helping people pay medical bills. Big Brother must really have it in for us!
Don't worry Cory, sequestration has done a great deal to kill real scientific research...although I heard that South Dakota's reliance of the science of astrology is still relevant. I mean after all, the Reagan's regularly consulted an astrologist for the big things.
Between that and allowing psychics back to Deadwood, we should be covered on all the science we need to know. #Thanks SDGOP.
There you go again Dr. Weiland, injecting facts into the debate. Why you gotta harsh on everybody's "core principles"? ;p
Anne- Insurance aside-
10 years ago I said the same thing, now, as a mother of a special needs child, I realize how much I assumed, misunderstood, and just how ignorant I was about the subject of autism and special needs. I am very happy for Temple, that she was able to learn how to control herself through behavior. However, autism, like all other special needs, is a wide spectrum of differences of needs from one person to another. You may not have meant it, I will give you the benefit of doubt, but your comment is incredibly offensive to those of us living with these daily, moment by moment, and second by second decisions and choices. Many of these people can not function without medication. With medication, many people are able to be productive citizens, and children can be learning in school settings. Trust that these medical choices for our children is never an easy decision or plan of action because these miracle pills, as you make them out to be, do NOT make them "all better". You clearly don't have much experience in this or you would know that. Also trust that the public educational system is also involved with these children, helping is any way they can. Keep our schools properly funded and you can ensure they always will be. For the people that would take advantage of the bill, or not get other proper services, those people will be the same people no matter what is passed.
"No health benefit plan may deny payment or reimbursement for the necessary diagnosis or treatment provided by a certified behavior analyst or a health professional licensed in South Dakota."
Doesn't Applied Behavior Analysis have to be carried about by certified members, thus it should be covered when the bill passes??