Wednesday, February 25, 2009

GOP should love Clay's Law

Opinion piece submitted to the Deseret News by Judith Miller, Ph.D.

Senate Bill 43, otherwise known as “Clay’s Law,” would require insurance companies to provide coverage for early intensive behavioral intervention for children with autism. Yes, it’s a mandate, and yes it will cost some money. But the amount of money it will save taxpayers in the long run should please anyone concerned about government spending: This IS the fiscally conservative way to address autism.

The bill proposes we pay a little now, in order to save A LOT later on. Specifically, it will result in a less than 1% increase in insurance premiums. In addition, it requires $1.9 million now to cover the administrative costs to PEHP (state employees’ own health insurance plan). While this is a lot of money, let’s put it in perspective:

Untreated autism is estimated to cost approximately $3 million over the person’s lifetime. Intensive early behavioral intervention (the type covered by the bill) can cut this down by $1 million. That means the bill could pay for itself with the savings from just three or four children.

But the bill would affect many more than three or four children. Autism occurs in 1 out of every 150 children. The insurance companies affected by this bill cover 30% of the state’s population. Thus, approximately 100 children born each year could receive intervention under this bill. For every 100 children treated, families and taxpayers could save $100 million in future care costs. If your financial advisor could get this kind of return on an investment, he would tell you to scrape together every nickel you could find to do it.

And why should medical insurance cover this instead of a state entitlement? Because the intervention we are talking about is a healthcare intervention. It prevents a medical condition (autism) from becoming worse, and works toward restoring normal brain functioning. We use this model to treat strokes and traumatic brain injuries all the time. And like strokes and injuries, treatment is most effective immediately after the injury. In autism, intervention works best when the child is very young and the brain is still “plastic” enough to change. That’s why the American Academy of Pediatrics recently recommended all children be screened for autism as toddlers.

The fact that this evidence-based treatment is not covered means the vast majority of children cannot access it. The window for dramatic treatment results closes in childhood, and then our families, schools, and eventually the state must pay much more for higher levels of care. Let Health and Human Services cover the costs for treating those who cannot access this through their insurance, or who require support even after intervention has been provided. But whenever possible, health insurance is the appropriate forum to provide this restorative intervention.

Some of our leaders have worried that if we “help” children with autism, then others will come knocking for assistance. A true steward of your tax dollars would enthusiastically welcome a proposal from any group that could result in such dramatic savings for taxpayers.

Utah has a relatively low rate of outmigration compared to other states. People born here generally stay here their entire lives. Our state will benefit directly from providing intervention to our own children, in the form of tremendous savings when these same children enter our schools and then go on to become adults. In a climate of severe budget cuts and concerns, this is EXACTLY the approach our state needs.

Judith Miller, Ph.D.
Associate Professor
University of Utah

This is Dr. Miller’s view from her own personal experience, not on behalf of the University of Utah or other agencies.