Health Care Reform Stirs Hopes, Fears for Parents of Autistic Children
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By Sarah Mueller / NTNewsNet.com — Twenty-one-year-old Ben Burns can only speak one word: up. He is severely autistic and his father Dan Burns has had to spend thousands of dollars getting Ben medical treatments not covered by his health insurance.
“We’ve really been around the mulberry bush trying to get, recover, some of the cost,” Burns said.
Autism spectrum disorder is defined by the National Autism Association as a neurological disorder. The illness impairs the brain’s ability to develop normal cognitive, social and communication skills. Texas Department of Aging and Disability Services reported that 11 out of every 1,000 children in Texas have the disorder.
Many insurance companies consider autism a pre-existing condition. Or they won’t cover some of the treatments because they’re labeled as educational or considered experimental.
While the medical costs vary for parents of autistic children, some families pay as much as $5,000 a month to provide proper medical care not covered by insurance. While the Burns family is able to afford thousands of dollars in out-of-pocket expenses for treatment, state-run clinics like LifePath Systems in Collin County see low income and uninsured residents. Texas has the largest population of uninsured people in the country, according to the U.S. Census. North Texas parents hope this will change with the new healthcare bill passed by Congress last month.
But Jannie Herchuk, partner with Deloitte, the international accounting and consulting firm, said there are some misconceptions from the bill. While the new bill will give children with pre-exisitng children access to coverage this year, that safeguard is not available to adults until January 1, 2014.
“Certainly, with regard to adults with pre-existing conditions, that’s not coming this year,” Herchuk said.
But some benefits will kick in this September.
Burns is covered by his mother’s insurance and Medicaid, but he is starting to age out of his current coverage. Herchuk said the new regulations allow Ben to stay on his mother’s insurance until age 26. It also expands federal funding for Medicaid and removes lifetime and annual caps on how much the insurance company will pay for medical treatments.
Insurance companies have to spread risk, said Tom Currey, President of National Association of Insurance and Financial Advisors. There’s not a lot known about autism and the disease is still be researched, he said.
“It’s one of those conditions that’s like an open checkbook,” Currey said.
While parents and insurance companies argue over who should pay, one thing everyone agrees that no one knows how the new legislation will work. Right now, there aren’t a lot of guidelines for such a large and complex bill, Herchuk said.
“Is it going to be murky for a while,” Herchuk said. “Yes, it is.”
Burns said he’s still looking into the new healthcare reform bill will mean for his son. But he says right now it’s looks good.
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