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Governor Vetoes Bill To Mandate Autism Health-Insurance Coverage

By Cara s Politics on the Hudson October 21, 2010

Gov. Paterson has vetoed legislation that would require state-regulated

health-insurance companies to cover " evidence-based, peer-reviewed and

clinically proven " treatment and therapy for people with autism spectrum

disorder, saying it would amount to an unfunded mandate because it would

increase health-insurance premiums state and local governments pay and the

premiums for Child Health Plus, a government insurance program for children

whose families are not eligible for Medicaid. The total annual cost of the

legislation could be $70 million, according to the governor, and the state

budget does not include money to pay for that.

The cost of commercial health insurance would also grow if the legislation were

implemented, and could lead to loss of coverage for some New Yorkers, he said in

the veto.

The state has a number of programs that provide early intervention for children

with autism and other developmental disorders, although many families have to

pay a significant amount of money each year to get all the services they believe

their children need.

Paterson, who has about two months left in his term, wrote that he is " extremely

sympathetic to the very real struggles faced by families of individuals " with

autism spectrum disorder, which he said is a priority for society to address.

Autism spectrum disorder, which occurs in roughly one out of every 100 kids, is

characterized by difficulty with speech and social interaction and repetitive

behavior patterns. Symptoms vary depending on where children are on the

spectrum.

" It will be a subject of my continued advocacy as a private citizen. But now I

am governor, and I cannot sign a bill that would impose costs that the

Legislature does not fund, " Paterson wrote.

The bill has been the subject of intense lobbying by autism advocates who

support and those who oppose the legislation. It was sponsored by Sen. Neil

Breslin, D-Delmar, Albany County, and Assemblyman ph Morelle, D-Irondequoit,

Monroe County.

Opponents said it would hurt people seeking treatment for autism because of the

" evidence-based, clinically proven and peer-reviewed " standard, which is not

required for other medical problems, and would shift costs from insurance

companies to counties and taxpayers for early intervention services.

Sen. Craig , D-Nassau County, said he was disappointed the governor

vetoed the bill and said the Legislature should reconvene to consider an

override. This is part of a statement he released:

" I believe the governor's decision to veto legislation requiring health

insurance companies to cover some of the costs associated with autism is a

giant, misguided step backwards. I wish Governor Paterson, prior to rendering

his decision, spent some time with parents who have to work second jobs and have

taken out third mortgages in order to provide their children with much-needed

autism-related therapies. Health insurance companies have a responsibility to be

there when our families are in need. Governor Paterson's actions today have

unfortunately made it easier for them not to honor this commitment. "

The governor said another flaw in the autism bill is it would require the state

Health and Insurance departments and a few other state agencies to develop

regulations for health insurers within a year and update them regularly, but the

state budget does not provide them with the extra resources they would need to

do this. "

http://statepolitics.lohudblogs.com/2010/10/21/governor-vetoes-bill-to-mandate-a\

utism-health-insurance-coverage/#more-11166

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Assemblyman Morelle Criticizes Governor For Autism Veto

By Quinlan Greecepost October 21, 2010

Assemblyman ph D. Morelle, D-Irondequoit, today said he is " deeply

disappointed " that Gov. Paterson has vetoed a landmark bill that would

have extended health care coverage to families affected by autism.

" This was an opportunity to simply do the right thing for the ever-increasing

number of families whose children are diagnosed with autism, " said Morelle,

chairman of the state assembly's Committee on Insurance and the bill's primary

sponsor.

" As insurance chairman, I am always wary of adding new mandates and costs to a

health care system that's already too expensive, " Morelle said. " But parents who

pay health care premiums and are dealing with this diagnosis should not be told

that treatments for their children are out of reach. "

Morelle's bill would have prevented insurers from denying coverage on the basis

that treatments are educational rather than medical in their necessity. Families

would have been able to appeal denials to an independent review panel if an

initial grievance to the insurer was unsuccessful. All treatments included in

the bill's scope were required to have been peer tested and clinically approved.

Parents of children with autism and leading advocacy groups strongly supported

the legislation, which passed both houses of the state legislature unanimously.

" This proposal would have addressed a fundamental lack of fairness and given

hope to families across New York, " Morelle said. He pledged to continue to fight

for a change.

>

> Hi,

> Does anyone know the status of NYS legislation S.2366/A.6001 mandating

> private

> insurers in NY for various treatments for those diagnosed w/ autism.

> Thanks for your help

> Amy Libby

>