There are good political and policy reasons for Congressional Democrats to pass the Senate Health Care Bill, hopefully with a reconciliation “sidecar,” but without one if need be. But I have a personal reason for my desperate wish to see the Senate Bill enacted. My daughter has autism.
In most states, including my home state of Washington, it is legal for insurers to discriminate against autistic insureds by excluding or severely restricting necessary therapy for their condition. For example, we are eligible for reimbursement of only sixty therapy visits a year under our current insurance, a fraction of the over two-hundred that our daughter needs.
Providing adequate therapy and meeting the other medical needs of her condition costs us around $20,000 per year out of pocket. This is on top of the more than $1300 monthly premium that we have been paying through COBRA for our otherwise pretty good, non-profit public-employee health plan since my wife left full-time employment with the state to work part time from home as a contractor in order to spend more time caring for our daughter.
When COBRA runs out, however, we will be in a far worse predicament. Our current plan at least covers diagnostic medical services for the team of doctors, nurses, and psychologists who help to design our daughter’s treatment and manage her medication, as well as for costly genetic screening and other testing to examine potential causes. But the group policy that my law firm provides to its employees has even more restrictive limits on therapy visits and diagnostic coverage.
And because I am a partner in my firm (and thus a self-employed part owner of the business), I would have to pay the entire $1800 monthly premium, which has been rising annually by double-digit percentages even as benefits have deteriorated. Plans in the individual market cost less, but they offer little in the way of autism benefits when they offer any at all.
The Senate Bill would outlaw autism insurance discrimination nationwide by requiring that autism coverage be included in the basic benefits package. Without it, I truly do not know what we will do when our current coverage runs out.