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Editorial: Utah autism mandate has too many loopholes

Published March 19, 2014 1:01 am

Utah bill exempts some employers
This is an archived article that was published on sltrib.com in 2014, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

The Legislature came closer than ever this year to helping the thousands of Utah children who have been diagnosed with autism spectrum disorder. But legislators still managed to fall short of doing what they should to require all insurers to cover treatment for the disorder.

Sen. Brian Shiozawa, R-Cottonwood Heights, who sponsored Senate Bill 57, promised its passage in the just-completed legislative session would prevent the "incalculable anguish" that many parents suffer while trying to get therapy for their children. But he's not telling the whole truth.

Only health plans provided by large employers and individual plans sold or renewed starting Jan. 1, 2016, are subject to the mandate. Small businesses and self-insured companies — including some of Utah's largest employers — are exempt.

That's unconscionable, given that Utah is considered to have one of the highest, if not the highest, rates of autism in the country and that Applied Behavioral Analysis treatment, while effective, is prohibitively expensive for families.

Among the large companies affected by the self-insurance loophole is Intermountain Healthcare, which, ironically, markets autism care at its hospitals, provided by its doctors. But the health insurance side of the company doesn't cover those services for Intermountain's 33,000 employees.

These loopholes should be eliminated. All children, not only those whose parents have a particular type of insurance coverage or are lucky enough to win the lottery set up by the state to cover a few children, deserve care.

To their credit, the University of Utah and its hospitals and clinics are considering adding autism coverage before the legislated mandate requires it. Some large companies in Utah already provide limited or complete coverage for their employees and families.

Intermountain Healthcare and Deseret Mutual, the health plan for employees of The Church of Jesus Christ of Latter-day Saints, and others not required to cover autism therapy, should follow their lead. Children of their employees are no less deserving or in need than those fortunate enough to have the benefit.

Cost is not a valid argument against making the change. The 34 states that require autism coverage report the per-member, per-month premium cost was 15 cents the first year and 31 cents the second year, according to the national group, Autism Speaks.

That's little enough to give children a chance to live happy, productive lives.