South Carolina Joins Push for Insurance Coverage

Governor should support coverage for autistic children
Bill would provide needed therapy for young people up to $50,000 a
year

Published: Tuesday,

May 29, 2007 - 2:00 am

State lawmakers approved a bill that would require private insurance
to cover treatment for autistic children. Gov. Sanford should sign the
bill.

A spokesman for the governor on Friday said the bill had not yet
reached Sanford for his review. In the past, however, Sanford has been
reluctant to impose mandates on the insurance industry. The hope among advocates
is that he will set aside his personal misgivings and approve this needed
legislation.

In 2005, a similar situation arose: Sanford, despite his reservations,
allowed a bill to become law that required many private health plans
to provide greater coverage for serious mental illness. Sanford refused
to sign the bill but neither did he veto it, and by his passive support it
became law.

The current autism bill is equally worthwhile. Autism, a disease that
can severely impair a young person's ability to communicate, form
relationships and adapt to change, is the only neurological disorder not required
to be covered by private insurance in South Carolina. The bill would require
insurance to pay for treatment for children, age 16 and under, up to a
maximum of $50,000 a year beginning in July 2008.

In South Carolina, about 2,000 children under 18 have autism. Advocates
argue that early intensive therapy can do wonders for some autistic
children. Advocates say that about half of children who get at least
40 hours of therapy a week can enter the first grade on time. Another 40
percent make considerable progress, they say.

But that therapy can cost up to $75,000 a year, putting it out of
reach of many families with autistic children. Advocates say families across
this state are forced to get second mortgages on their homes or face
bankruptcy trying to provide the intervention their children need. Or they face
the heart-wrenching experience of placing their children in group homes or
institutions -- although there's often a 15-year waiting list for such
institutions.

Even though therapy may be costly for insurers, it could save the state
considerable sums in the future. An autistic child who receives
insufficient treatment sometimes can end up being cared for in an institution at
taxpayer expense. That can cost the state $4 million to $7 million for each
patient.

Compassionate consideration for children suffering from autism helped
persuade state lawmakers to follow the lead of at least 17 other
states that require coverage. Early intervention for children also may save the
state millions of dollars in the future. Gov. Sanford should sign the bill
and give autistic children the opportunity to lead more productive and
perhaps even more fulfilling lives.