Amendment of § 38.2-3418.17. Coverage for Autism Spectrum Disorder:
Distinguished Gentlemen and Ladies of Virginia,
The new year is nearly upon us and it is almost time to get back to the work of legislating. I have been patiently waiting for this time of year to renew my call for the amendment of the current law § 38.2-3418.17. Coverage for autism spectrum disorder:
A. Notwithstanding the provisions of § 38.2-3419, each insurer proposing to issue group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing group accident and sickness subscription contracts; and each health maintenance organization providing a health care plan for health care services shall, as provided in this section, provide coverage for the diagnosis of autism spectrum disorder and the treatment of autism spectrum disorder in individuals from age two through age six, subject to the annual maximum benefit limitation set forth in subsection K. If an individual who is being treated for autism spectrum disorder becomes seven years of age or older and continues to need treatment, this section does not preclude coverage of treatment and services. In addition to the requirements imposed on health insurance issuers by § 38.2-3436, an insurer shall not terminate coverage or refuse to deliver, issue, amend, adjust, or renew coverage of an individual solely because the individual is diagnosed with autism spectrum disorder or has received treatment for autism spectrum disorder.
I would like to see this law amended:
• Replacing "from age two through age six" with "of any age".
• Striking " If an individual who is being treated for autism spectrum disorder becomes seven years of age or older and continues to need treatment, this section does not preclude coverage of treatment and services."
By doing so this law will become a benefit to the people of Virginia and families with disabled children, instead of the hidden nightmare that it is now. As autism does not disappear with age this law needs to be amended to recognize that fact. It will also become the envy of the nation by being the first law to truly ensure the coverage of autism for all citizens of the state no matter their age.
I know that the legislators that created this law and saw it to fruition believed they were doing the right thing for the disabled children of Virginia and their families. The problem is that by including an age limit this law has effectively outlawed insurance coverage for autism for anyone over the age of seven. I know this was not the intent as "suggested" by the law itself in the section that reads:
If an individual who is being treated for autism spectrum disorder becomes seven years of age or older and continues to need treatment, this section does not preclude coverage of treatment and services.
The problem is that this language is taken by the insurance companies and the Virginia State Corporation Commission that oversees them as only a suggestion. This oversight must be corrected.
Even though autism is not a partisan issue, let’s look at it this law from the Republican side (majority). The Virginia Republican Creed as written by Dr. Max Charles Graeber states:
That the free enterprise system is the most productive supplier of human needs and economic justice,
That all individuals are entitled to equal rights, justice, and opportunities and should assume their responsibilities as citizens in a free society,
That fiscal responsibility and budgetary restraints must be exercised at all levels of government,
That the Federal Government must preserve individual liberty by observing Constitutional limitations,
That peace is best preserved through a strong national defense,
That faith in God, as recognized by our Founding Fathers is essential to the moral fiber of the Nation.
This law violates two of the six parts of this creed. By including an age limit in § 38.2-3418.17. you have removed the opportunity for 12,000 plus children to improve themselves so that they may be responsible and independent adults in the future. Without treatment most of them will grow up to be dependent on the state and federal government to take care of them for the rest of their lives. As most of these children will require welfare, disability, Medicare, and other services to take care of them. That is a violation of the fiscal responsibility part of the creed. The cost to the insurance company is far outweighed by the cost to the state. What is more important to the republican party then lowering the necessity for government assistance?
The Republican Party of Virginia also states that their mission and purpose includes common-sense conservative values and principles including:
• lower taxes;
• less and smaller government;
• personal responsibility;
• creating opportunities for anyone;
• protection of life;
• empowering families;
• and defending freedom and liberty.
§ 38.2-3418.17. violates four of the seven values and principles of the republican party. This law prevents autistic children and their families from taking personal responsibility for their medical care. It prevents opportunity for these children to grow into responsible adults. It does not provide care that will protect the lives of these children. And finally it does not empower families to be fiscally responsible by forcing them to seek government assistance.
As a father of a child with autism I can tell you that this law has done nothing but disrupt my sons medically necessary therapy and increase my out of pocket costs. For the insurance companies you have given them the ability to defraud their customers by denying the existence of a well know, documented, and understood disorder. That may sound harsh, but it is true. This law does not allow me and many others to maintain our fiscal independence and responsibility. We are all forced to seek a Medicare waiver (very difficult to acquire) so that we can provide care for our children without bankrupting our entire family to do so. As a proud American it pains me deeply to seek government assistance, but this law forces my hand. The necessity for such an amendment is easily apparent to anyone. There is no logical, moral, or ethical stance that can be taken or argued to support this law as it stands. If you have one please present it me or someone else whom has a child with autism so that we can clarify your perception of reality. Let’s do the right thing this year and amend 38.2-3418.17. Coverage for autism spectrum disorder.
Thank you for your time and attention, feel free to contact me any time.
(571) 762 -6740