Tuesday, March 24, 2015

An Open Letter to the Insurance Committee of the Georgia House of Representatives

A Child of Georgia
2 year old Caleb
Diagnosed with Severe Autism

March 23, 2015

​Dear Georgia Lawmakers:

As a 38-year old mother of a 2 year old boy recently diagnosed with severe autism (Level 3), I write to implore you to end insurance discrimination against autistic children by voting SB1 (Ava’s Law) out of committee and into law in 2015.

When my son Caleb was diagnosed in December 2014, I was appalled to learn that his autism therapies were excluded from coverage because autism is considered a development delay and treatment is classified as “educational” and not “medical.” I asked myself, “How can this be? Autism is a biologically based condition that requires a medical doctor to diagnose. Autism is inherently medical.” In my research I found that in the late 80’s/early 90’s and continuing today, the insurance industry lobbied to have autism classified as “educational” in order to externalize the cost to tax payers and protect their profit margins. This set the national precedent and policies for blatant discrimination against autistic children. With that history, a few things for you to consider:

• 1 in 64 children have autism in Georgia.

• Autism is the most prevalent childhood medical condition; more common than childhood cancer, juvenile diabetes, and pediatric AIDS combined.

• Cost of lifelong care can be reduced by 2/3 with early diagnosis and intense early intervention, such as Applied Behavioral Analysis (ABA) therapy.

• Nearly 50% of children receiving intense ABA therapy mainstream by kindergarten and are indistinguishable from typically developing peers. Many bypass special education all together and go on to be productive members of society.

• Autism is a MEDICAL condition; costs for medical therapies should be not externalized solely to the public education system and tax payers.

• Therapies for other neurological disorders are generally covered under health insurance, including behavioral therapies. Autism is only excluded due to the successful lobbying efforts of insurance lobbyists.

• Critical development is between birth to five years old. Every day counts. Ava’s Law has failed to pass for six straight years in Georgia at the expense of children. How long must this go on? How many children will continued delays impact under your watch?


• Discrimination is the unlawful treatment of another person. The unlawful treatment of children with autism manifests in two ways: Less favorable treatment, treating a person with a disability less favorably compared to someone without a disability and failure in the obligation to make a reasonable adjustment for the disability. Denying medically necessary therapies to autistic children is blatant, unapologetic insurance discrimination.

• Actuary science describes the minimal cost to companies and individuals, but what about the substantial cost to children?

• Public education, particularly special education is not enough therapy for autistic children. Autistic children pushed into special education without adequate medical therapies are effectively being relegated to a lifetime of special needs support, public assistance and face an unemployment rate upward of 90%.

• While Ava’s Law only impacts state regulated insurance plans, it still covers 1.8 million Georgians. To suggest there is no need to pass Ava’s Law because the majority of children are covered under ERISA plans flies in the face of reason and good sense. What that reasoning implies is that legislation is not worth passing if it only impacts a certain percentage of the population. How many laws are enacted that only apply to a certain segment of the population? Most! Even if only one child were helped by Ava’s Law, that is still one child helped. In this case, the numbers are substantially larger and growing. Further that reasoning implies that children covered under state regulated plans should not receive behavioral therapies just because their parents work for a small or medium size business. That too is discrimination.

So far in 2015 three additional states passed autism insurance reform, bringing the total to 41. Must Georgia be the last?

For over a decade, insurance companies and business lobbyists have successfully lobbied against our children. Those practices continue today unless you put a stop to it. It is beyond the pale that we live in a nation where it is necessary to legislate and mandate humane treatment for children. Yet that is exactly what is asked of you as a Representative of Georgia. The awesome
responsibility before your distinguished body will fundamentally shape the lives of hundreds of thousands of children and their families in Georgia. Your decision is whether to bow to the wishes of those lobbying against the interests of Georgia’s children or help maximize their potential. Please don't let the Georgia Chamber of Commerce or the National Federation of Independent Businesses bully you into voting against Georgia's children.


This is a matter of human rights. This is a matter of civil rights.

This is a matter of equal opportunity for all of Georgia’s children.

Please take a stand against business interests that seek to neglect our children by denying medically necessary treatment. Please be a voice for the voiceless and take a stand for autistic children.

Thank you for your consideration.

Sincerely,

Tricia Harris

Bio: https://about.me/triciaharris

Chattanooga Times Article: Hope for autism help: Georgia lawmaker, supporters hope 7th time will be the charm for bill

WSB Radio Article: Hearing on autism bill set for House committee today

Monday, March 23, 2015

WSB Radio: Hearing on autism bill set for House committee today


WSB Radio
Atlanta — 
A state House committee will hold a hearing this afternoon on a bill that would force insurance companies to cover autism treatment for kids through age 6.

The measure, which passed the state Senate unanimously early in the legislative session, would raise insurance premiums by a few dollars.
But Rep. Richard Smith (R-Columbus) has blocked passage of the bill in the House. As chairman of the House Insurance Committee, he says the bill would only impact around 15 percent of the state’s population who work for small companies.
“Because your large self-insured companies are federally regulated, we have absolutely no say so in what they do or what they do not do,” he tells WSB’s Sandra Parrish.
Smith says he has no plans to vote on the bill as it currently is written.
“We’re telling small business or those that are self-insured, ‘we’re going to raise your premiums to cover this’; and I have an issue with that,” he says.
But Tricia Harris of LaFayette says insurance companies should have been paying for the treatment all along calling it’s a neurological disorder.  She has been lobbying lawmakers all session on behalf of her 2-year-old son Caleb who has autism.
“Arguably the insurance companies took a free ride for over ten years at the expense of our kids; they should have been covering it,” she says.
Harris pays out of pocket for her son’s treatment, but says there are many other parents who can’t afford it. Statics show one in 68 kids are diagnosed with autism in the U.S. each year.
“Thirty-eight states have passed these mandates, so you have to ask yourself why this mandate is necessary to begin with,” she says.
Last year the state Senate attached its autism legislation onto the House medical marijuana bill in an effort to get it through.  The House baulked and neither bill passed.
This year, the Senate has come around to the House version of medical marijuana legislation which is expected to receive final passage as soon as this week.  But the same fate isn’t likely for the autism bill.
“I don’t pass legislation out that I don’t feel is ready,” says Smith.
http://www.wsbradio.com/news/news/local/hearing-autism-bill-set-house-committee-today/nkcXd/