Opinion Extra

Legislators should ensure parents of autistic children get fair insurance coverage

South Carolina State House. 1/9/19
South Carolina State House. 1/9/19 tglantz@thestate.com

Why must our Legislature be beholden to big money special interests???

My daughter was diagnosed with autism three years ago, throwing me into a challenging, exhausting, heart-wrenching, rewarding, exciting, frustrating, and overwhelming journey.

One of the worst parts: realizing that the therapy my daughter needs, that is prescribed by her doctor, and that would change her life is not covered by our health insurance.

In South Carolina, Ryan’s Law requires that large group health insurance plans and the State Health Plan cover autism therapy, but with many restrictions. It was enacted 12 years ago, and we now know that those restrictions are inappropriate. The data proves the therapy’s efficacy, and the costs are reasonable when distributed across policyholders. This law is working — for those fortunate to be covered by it.

My daughter has an individual health insurance plan, but this therapy is excluded in that kind of plan.

Why? I pay premiums too. Why doesn’t she have access to the same coverage?

I am also a small business owner. I could purchase small group health insurance, but S.C.’s law also allows the therapy to be excluded in those plans.

Autism advocates are in their fifth year of attempting to expand Ryan’s Law to include the individual and small group markets. Bill S.135 passed the Senate in 2015 but was blocked in a House committee. Bill H.3790 passed the House in 2017 but was blocked in a Senate committee. Now bill S.363 has been filed by Sen. Tom Davis. All three bills have essentially the same language.

Why has the same language passed both the House and Senate but still not become law? The powerful, big money insurance industry stopped it.

An alternate proposal was introduced by the insurance industry last year. The entire autism community opposes the proposal, but it managed to be fast-tracked through the Senate Banking and Insurance Committee. Fortunately, autism advocates stopped the bill on the Senate floor. But the same bill has been pre-filed this session (S.74).

S.74 puts everyone with autism into the State’s High Risk Pool. The state then hires an insurance company to create a rider for purchase by those in need of autism therapy. This proposal does not distribute the cost among all policyholders, so the rider would be very expensive. State money pays consulting fees to the insurance company. Then, if there is money left over, funds would help families buy the rider. How do families qualify for help? No one knows. Is the money guaranteed? No. Where does the money come from? Your tax dollars.

S.74 is a slush fund for big insurance. The insurance companies get paid consulting dollars for administering the program and they are paid premiums for the rider. All in addition to health insurance premiums we already pay!

As a taxpayer I am angry that anyone would use our tax dollars so irresponsibly. (State tax dollars go further in Medicaid, which covers this therapy, because there is a federal match, making it more fiscally responsible.)

As an autism mom I am offended by a proposal that requires me to pay extra for something that should be covered by health insurance.

Legislators: Do the right thing! Vote favorably on S.363 and help my daughter and thousands of other children get needed therapy, and stand up to special interests that do not have our citizens’ best interests at heart!

Citizens: If you agree with me, please contact your legislators and ask them to support bill S.363 and help autism families in South Carolina!

Emily Wright is a wife, mother of three girls, one with Autism Spectrum Disorder, a small business owner and a member of the Palmetto Civitan Club.