We are fortunate to live in a society that values advances in medicine that are based on scientifically sound research.
It’s unfortunate that insurance companies such as HMSA have not kept pace with these changes and do not cover proven treatment methods for certain segments of our community.
As a recent article aptly pointed out, such short-sightedness can permanently damage children, keeping them from reaching their fullest potential ("Funding early autism treatment will save money in the future, bill advocates say," Star-Advertiser, April 3).
Health insurance companies such as HMSA have dramatically overstated the cost of providing this benefit and are putting their own interests ahead of residents who have long been paying their health insurance premiums. The whole point of insurance is to spread risk and cost among an entire population, so that catastrophic expenses are not heaped upon specific individuals or groups.
Senate Bill 2054, advancing in the final weeks of this legislative session, advocates a more equitable system for families with children who have autism spectrum disorders. In its current form, the bill would require health insurance plans to cover autism spectrum disorders.
If passed, state-regulated health plans would be required to cover proven treatment methods such as applied behavior analysis, which can dramatically improve the quality of life for children and preempt the need for more costly services down the road. Early diagnosis and intervention is critical, but there can be dramatic results no matter what age treatment begins. The key is to reduce barriers to the care children need.
Evidence suggests that techniques such as applied behavior analysis have been effective at mitigating, reducing or eliminating the effects of autism. Both the American Academy of Pediatrics and the U.S. surgeon general endorse applied behavior analysis. The treatments may seem costly in the short run, but millions of dollars are saved over a lifetime by the early utilization of treatments.
Currently, Hawaii’s parents often put their financial security at risk so that their children can receive appropriate care. It is unconscionable that this is occurring in Hawaii, which has one of the highest rates of lives covered by health insurance in the nation.
It is even more tragic that many families forego treatment for their children altogether due to high out-of- pocket costs. With the U.S. Centers for Disease Control and Prevention’s recently updated prevalence rate of autism now up to 1 in 68 children it’s time to update insurance policies and health plans.
Under the Individuals With Disabilities Education Act, the Hawaii Department of Education is required to provide services for children with autism. However, the DOE is an educational institution, not a therapeutic one, and cannot provide all the medically based therapy that children with autism need. We must make services to children with autism a covered benefit through health insurance so that families have access to effective treatment from medical professionals.
Thirty-six other states have already made autism treatment a mandated benefit. There is no further need to study the costs of this issue. By passing this bill, legislators will help enable children with autism get the treatment they need. The Hawaii Disability Rights Center and numerous other organizations and individuals have united to plead the case for fairness.
Autism is becoming more prevalent and the cost of care is rising. Failure to take action will only cost our state more in the long run.