MIRS BREAKING NEWS: Autism Insurance Reform Package Clears Senate — 1:15 p.m.

The Senate today passed a three-bill package on autism insurance coverage championed by both Gov. Rick SNYDER and Senate Majority Leader Randy RICHARDVILLE (R-Monroe).

The bills are SB 0414, SB 0415 and SB 0981. SB 0414 passed 29-9, with all the no votes coming from Republicans. SB 0981 passed 28-10.

Sen. John GLEASON (D-Flushing) lauded Lt. Gov. Brian CALLEY, whose daughter has autism, for taking the lead on the effort.

“You have become the face of this issue . . . because you were bold enough, really courageous enough, to put your family issues before 10 million Michiganders,” Gleason said.

The package moved out last week from the Senate Health Policy Committee (See “Autism Coverage Bills Sent to Senate Floor,” 3/8/12).

Senate Appropriations Chair Roger KAHN (R-Saginaw) lost amendments to the bills that would sunset the proposed law on Jan. 1, 2015.

“What is so difficult about a sunset?” he asked. “It allows us the opportunity to revisit the issue.”

On SB 0981, Kahn’s amendment capped spending at $30 million. He said it would limit “the amount of damage this bill will do in attempting to do good.” That also failed.

He raised his concerns about revenues coming in below estimates, as he’s done for several years. He said the bills are “important to me,” but it’s important not to “rob” those suffering from ailments like hemophilia from funding, as well. He said that the administration’s estimate could be low, arguing that similar legislation cost $80 million in Minnesota.

“Members should know this is an increase and ongoing cost, undefined but certainly increasing substantially,” Kahn said.

Richardville won amendments to each bill that would make the law go into effect on Oct. 1.

SB 0415 sponsor Sen. Tupac HUNTER (D-Detroit) said today “marks an important milestone in the Senate, but more importantly, for Michigan families.” He said he was approached five years ago by a constituent whose child has autism, which inspired him to introduce legislation.

An attempt by Sen. Rebekah WARREN (D-Ann Arbor) to add mental health parity to the bill via a substitute was shot down on a 18-20 record roll-call vote. She said it would “enhance this compassionate legislation.” She said she is “proud” to vote for the autism

bills and isn’t trying to kill legislation, but she believes adding all brain disorders would make the bill better.

She said her sub provides “off ramps,” like in Arkansas. If there’s an increase of more than 1 percent in expenses for businesses, they can opt out.

Gleason said he backs parity because otherwise “we’re picking one kid over another. . . . Let’s not leave anybody behind. We shouldn’t. We shouldn’t.”

But Sen. John PAPPAGEORGE (R-Troy) said that lawmakers have to agree on a definition of mental health disorders. He said he was concerned that substance abuse could be included, something he said the state couldn’t afford.

Advocates argue that it would decrease expenses to businesses to include all neuropsychiatric disorders, but the Michigan Chamber of Commerce and labor groups have long opposed parity. The Snyder administration and Richardville also didn’t want that added to the package. Michigan is one of seven states without mental health parity.

MIRS has learned that Republicans like Sen. Judy EMMONS (R-Sheridan) were courted to introduce an amendment, but the Snyder administration voiced strong opposition.

The bills allow insurance carriers or third-party administrators to get reimbursements from the state for any autism-related claims, a compromise with business groups that have opposed the mandated health coverage. The bills create a $50,000 cap.

Under the package, the Department of Licensing and Regulatory Affairs (LARA) would be charged with creating and implementing an autism coverage incentive program through which carriers could seek reimbursement for paid claims.

LARA is also required under the bills to submit annual reports to the Legislature and the state budget office on funding the incentive program has awarded. Snyder has suggested that up to $15 million be deposited into the new state fund.

Read, then bookmark our Autism Insurance Reference Page to stay up to date as this battle continues in the MI House.

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“We shouldn’t look at this as a mandate, but a moral public responsibility,”

- Sen. John Gleason, D-Flushing

This afternoon there will be a vote in the Senate Health Policy Committee on the Autism Insurance Reform legislation. Should it pass out of committee the hope is that it will be on the floor of the MI Senate within a week for a full Senate vote before heading over to the House, where the process will start over again.

Supporters of the legislation are hopeful while opponents are doing everything they can deny, block or change and weaken the legislation.

Which brings up the question I’ve gotten repeatedly the last couple of weeks  …..

“Who the heck wouldn’t want to see children with Autism receive coverage?”

In an effort to answer this question, while also addressing some of the “WHY” behind the “WHO”,  I dove into the testimony that’s been given to the MI Senate Health Policy Committee regarding this legislation. The result of this research is listed below …..

Business Interests Opposing 

The Economic Alliance for Michigan (members include Blue Cross Blue Shield of Michigan)

• Letter Opposing This Legislation
• “strong opposition to any state-imposed health insurance mandates”
• “purchasers …. should be able to determine”
• “impact only about a third of Michiganians”
• Board of Directors: The Economic Alliance for Michigan

Grand Rapids & Detroit Chambers of Commerce (amongst other groups)

• Talking Points Cheat Sheet
• Will only extend coverage for less than 1/4 of Michigan’s families
• Will increase costs and leave more Michiganders uninsured
• Diminish and erode employer and collective bargaining rights

The Arguments Being Made By Those Opposing This Legislation

“This report shows good news on two fronts,” said John M. Huff, (Missouri) state director of insurance. “First, it shows that the new law has already helped thousands of Missourians. Second, it shows the autism mandate should have minimal impact on health care costs and insurance premiums.”

Concerned that 1 of every 110 children has been diagnosed with autism in Michigan?

The prevalence of children with depressive and anxiety disorders in much higher.

(source: Literature from Michigan Partners For Parity )

In a nutshell the MHP argument is …. this legislation doesn’t go far enough because it doesn’t cover  every mental health condition and every treatment for every mental health condition (or some variation thereof) . It’s not that there’s NO coverage it’s that it’s not “sufficient”.  Some even go as far (as seen above) to almost make the argument that if you think Autism is bad wait til you hear about OUR problems.

There IS a Federal Health Parity law that helps provide mental health parity but DOES NOT cover Autism. A number of people gave testimony making this “Mental Health Parity” argument. Some were professionals and some were parents. They’re desperately fighting for coverage for THEIR kids and that’s admirable. The problem with the Mental Health Parity argument is two-fold:

• There is already federal health parity legislation which, while not perfect, does provide protection and help for a number of conditions. However, for Autism ….. there’s no coverage or protection.

• There is not the support for Mental Health parity legislation. It’s not a close vote. It’s not on the brink. It simply doesn’t exist in the numbers necessary to get it passed. While Mental Health Parity might be an admirable goal trying to ADD it to this bill won’t get a result that covers EVERYBODY. What it will do is get a no vote that will continue the discrimination against families with Autism while not upgrading the MHP coverage.

So are the supporters of this Autism legislation really ignoring or leaving behind those fighting for Mental Health Parity?

Of course not. Just because the Autism legislation doesn’t include full Mental Health Parity doesn’t mean that those that support it DON’T support parity ….. it simply means that we support seeing an end to the discrimination of children and adults with Autism in MI. Unlike the MHP argument we’re not fighting to IMPROVE coverage ….. we’re fighting to GET coverage.

To be fair, while a number of folks and groups have testified against legislation that doesn’t include parity, many of them do still ultimately support the passing of this Autism insurance legislation. They might like to see it made better (by their definition) but they don’t want to see continued discrimination just because they can’t get what they want. That’s a stance I can respect.

Then there’s the other group, they’re the one’s that says it’s all or nothing –  either they get what they want or kids and adults with Autism in MI can continue to be discriminated against. With that contingent I’ve got a problem. That strategy uses my child, and the 15,000 plus others in MI with Autism, as their political pawn simply to get what they want, everyone else be damned…. that’s wrong and honestly pretty reprehensible.

I support Mental Health Parity and would like to see our attitudes and support for mental health issues improved greatly in this country. Ending discrimination against those with Autism doesn’t hurt that cause ….. it’s PART of that cause!

I don’t support mandates! (as said by Politician)

“Through his office, Hune said he “doesn’t typically support mandates,” and that the Senate autism package likely isn’t an exception.” (source)

This is a typical response from folks that are opposing this legislation (we heard it last time too). It sounds good. It sounds very fiscally responsible …. but let’s think for a second.

What is a mandate? I looked it up and this is what I found ….

Mandate:

• Noun: a command or authorization or decree to act in a particular way
• verb to authorize or decree (a particular action), as by the enactment of law.

Since, based on the definition above, a law IS a mandate one could make the argument that if you’re not supporting mandates you didn’t pass many laws … except they did last year …. A LOT! The Michigan legislature and the Governor approved 323 new laws (source).  I checked Senator Hune (not to pick on him, there’s lots of legislators that like using the “no mandates” thing), he voted yes last year on a number of bills/laws/mandates and actually every year since he was elected. Yes numerous times, telling people what they can or can’t do and frequently with costs that would either be paid for by the government (via taxpayers) or by private entities.

So one could argue that it’s not that they don’t support “mandates” per se …. it’s that they don’t want to support THIS mandate. Fair enough legislators, nobody has to support legislation ending discrimination against children and families facing Autism …. but just be honest and say that, don’t hide behind some fake “noble stance”.

I don’t support mandates! (as said by business groups and lobbyists)

“We are writing to voice our opposition to any new mandated health insurance benefits”

- Michigan Chamber Of Commerce

This objection has nothing to with the legislation except that the legislation exists. The lobbyist who professes this is ONLY concerned about seeing no change made that could cost their clients so much as one penny. The long term or short term benefits of the change don’t matter . The morality of the change don’t matter. All that matters is ….. will this change potentially cost a penny. If the answer is yes … then they fight it.

This is where sarcastically I’d normally say “Wow! They’d fight a cure for Cancer!!!”  …. except they actually DID last year:

• Chamber Opposes Oral Cancer Treatment Coverage

Now THAT my friends is hard core!

It only covers (1/3 or 1/4) of Michigan families facing Autism and does nothing for those without insurance!

Ok, for starters this is legislation that reforms MI INSURANCE law. So yes …. by definition it’s not going to help (directly anyway) those without insurance. That’s like making the argument that a new law concerning families with a newborn won’t do anything for families without a newborn. Of course it won’t, that’s not what it’s trying to do.

It WILL cover families purchasing private insurance either on their own or through their workplace … this equates out to roughly 30% of the folks in Michigan.

Now, about that other 60 – 70% of families.

• Self-Insured: This law CAN’T by itself cover everyone in the state of Michigan because a large number of people work for companies that self-insure (think your big companies DTE, Big Three, etc.). The reason this law can’t change the rules for them is because …. well, literally it can’t. Those folks can only be told what to do by the Federal government. They operate, in this instance, outside the boundaries of what the State can do. They can be given incentives (which is exactly what the third bill in this package does) to do it but the State can’t FORCE them to do it.

• Medicaid/Medicare: The State of Michigan is currently being sued in a class action lawsuit for refusing treatment to children with Autism (source) under Medicaid. When Michigan either loses or settles this lawsuit it will open up coverage for children with Autism under Medicaid. Most agree that coverage for them is coming – one way or the other – very soon because the State is currently violating the law by not covering them.

Fourth, to make the argument that this legislation only helps the families that the legislators can legally help (under the insurance laws as they currently stand) is probably one of the most ridiculous arguments that could be made. Passing this legislation means that the MI Senate and MI House will be standing up to help the kids and families with Autism that they can directly pass a law to help …… isn’t that what they’re suppose to do?

Finally, this legislation WILL help EVERY person in the state of Michigan regardless of their insurance coverage or lack thereof for one very simple reason. By having coverage in the state of Michigan more centers, providers, therapists and specialists will come to (or stay in) Michigan because there will be a reason to stay here …. they’ll be able to get paid. Funny thing how getting paid to provide a service entices folks to provide the service.

Example: Currently in the State of Florida where they can get paid there are over 1,800 Board Certified Behavioral Therapists …. Michigan has 60. Or to put it another way …. Florida has 1,740 more behavioral specialists than we do.

Can you possible make an argument that it’s not better, as a person with Autism, to live in a state where there are 30x more people that can work with you, the schools, employers, law enforcement or the public in general? Of course not!

More people providing services means better service, cheaper service and a better network of support. All of that equates to a better standard of living and working for any person in the state with Autism.

So there you have it a ….not so very brief … breakdown of the opposition to this legislation with why they’re wrong (in my un-humble opinion). As always there’s at least two sides to every story so I’m sure they’d have a good rebuttal to my points. While I don’t agree with them I certainly respect the fact that they’re standing up for what they believe (or in the case of the lobbyists what they’re paid to believe). However, after an almost ten year battle to get coverage for these kids and end discrimination against them … here’s hoping the Senate and then the House does what’s right and protect our families.

One year ago I (along with a lot of other parents) was in the state capitol in Michigan advocating almost around the clock for three days for passage of Autism Insurance Coverage for Children in the state of Michigan.  Doesn’t seem like it would be a particularly hard thing to convince someone of, does it?  You have a child with a medical diagnosis.  A child with a real neurological condition.  A child that with early treatment and intervention has a great chance to overcome many of the hurdles that their medical condition would otherwise impose on them over the course of their lifetime.  To put it more bluntly, you help these kids and you give them a more promising, productive, rewarding future.

In the midst of what seemed like the final days before Spring Break in a middle school, we (the parents, therapists, children, etc. advocating for this legislation) watched as the legislators … many in their final days as legislators … ate cake and pizza and sang songs karaoke style on the floor of the Senate (seriously).  It was truly as if they’d gotten all of their work done early and were just counting down the final hours of their tax payer funded terms before they could all go home for Christmas break (you see Virginia in Michigan our Senators and Representative collect full-time paychecks but don’t necessarily put in full-time hours or work year round).  One of the things they forgot to do though was give the kids and families in Michigan battling Autism a chance to get their children the life changing help they need.  In what amounted to politics and political gamesmanship at its best (dirtiest?) the bill was blocked and kept as far away from the floor as it could because many (even those opposing it) knew that if the bill got to the floor of the Senate there were enough votes for it to get passed.  That would have been a life changing moment for thousands of kids and families in Michigan. But alas, it was not to be.

That’s history though and the point of this post is not to idly lament history.  My point IS to ask where the champions for our kids have gone in THIS session. You see, this year – 2011 – was supposed to be different.  A ton of new members in the Senate and House meant the entire process had to start over again but THIS time we had a leg up (or maybe not) …. because THIS time we had champions in high places that cared about this legislation (do they?).  But many of us are now, on the anniversary of the crushing defeat felt last year, wondering ….. where have our Champions (or potential Champions) gone?????

Where did Senate Majority Leader Randy Richardville (R-Monroe) go?  He had hearings last year.  Gave countless parents hope and encouragement as he toured around the state in 2010 heading up his Autism Insurance informational sessions.  He accepted awards and spoke at rallies talking about the need for Autism Insurance Reform. He was supposed to be a champion for Autism Insurance in the Senate. Despite the failure last year we were assured that he was a champion, we were assured the he was a fighter, we were assured he wouldn’t forget …. so where is he now as the LEADER of the Senate Republican Majority?

Where did our Champion Lt. Governor Brian Calley go?  He famously has a daughter with Autism.  He was a leading voice late in the charge for the passage of the Autism Insurance legislation last fall. He spoke out on the radio and even did a video on behalf of the legislation trying to advocate for its passage.  He took his shots from the opposition but kept charging. By his own admission his outspoken advocacy for the legislation was perhaps a bit late in the game but there is no doubt that his efforts, if ultimately unsuccessful, were important. You can see him all over the place these days as the Lt. Governor taking the Governor’s message and fight to the two chambers in Lansing and the media (the bridge to Canada, the budget, school funding, tax reform, etc.).  He had fire and passion last year for Autism Insurance Coverage for Michigan’s kids ……. but where is our Lt. Governor today?

Senator Jim Marleau – Chair of the Senate Health Policy Committee – He has supported Autism and disability rights issues for years.  He sits on the board of the nonprofit “Homes for Autism”. When it was announced that he would be the Chair of the Senate Health Policy Committee and that the Autism Insurance for Children bills would be assigned to his committee there was widespread relief.  With someone who understood the issue we all figured the odds of it getting locked and blocked in committee never to see the light of day on the Senate chamber floor (as happened last year) would be a concern we could shelf. A funny thing happened on the way out of the Health Policy committee though …… nothing (it’s like visions of last year all over again). Our potential Champion who could bring this legislation up in his committee and send it to the Senate floor, well, ummmm … he isn’t. Senator Marleau …… where are you?

Just to be clear I’m not disparaging any of these three Republican politicians. (I highlight Republican here because it IS the Republicans stopping this legislation just as it was last year.  As a conservative Republican it pains me to say this but the reason our kids in Michigan don’t have Autism coverage is because the Republicans … at least thus far …. have not wanted them to have it. The truth hurts but that doesn’t make it less true …. sadly.)  I have a tremendous amount of respect for them and believe that the leadership they could provide this State is much needed.

My frustration however is this ….. they’ve all elected to not be loud, vocal, aggressive advocates for our kids.  Despite their strength and influence and stature they’ve all elected to sit on their hands and not do anything.  Despite their vocal support of these kids and families and helping them at Autism related events ….. they’re not delivering.

Who knows, maybe I’m wrong.  Maybe behind the scenes these three potential Champions for our kids are working hard and trying to line up the votes. However, these Republicans are finishing up their first year in office. They’ve passed 231 new laws. Of those laws 95% of them have been laws championed and introduced by Republicans. That’s 231 new laws in less than a year.

So it’s not like they can’t get something they care about passed.

But not a whisper about Autism.

The rate of Autism and the number of births in the State of Michigan would suggest that over 1,000 additional children in the State of Michigan were diagnosed this past year. That’s over 1,000 additional families that are discovering that their insurance company WILL NOT cover their child.

They will not cover the life changing therapies.

They will not cover the interventions that literally will mean a savings of millions of dollars over the lifetime of that child.

Approximately 1,000 additional children were diagnosed with Autism this year and they won’t have coverage because our Senators and Representatives don’t think that they’re important enough to protect.

Michigan was one of the first states in the country to take up the Autism Insurance fight for our kids.  In the time that our State Senators, Representatives and Governors have done nothing, 29 other states have stepped up to protect their children.

A year ago I was in Lansing tonight working hard with other parents to try to get coverage passed that would have helped thousands of children and families across the state. We were fighting for our kids but we were also fighting so that those 1,000 children newly diagnosed this past year wouldn’t have to suffer like our children and families have had to suffer.

A year ago we watched the Senate singing karaoke on the floor of the chamber, glad handing each other while they ate pizza and cake and then snuck out of town after abandoning our kids.

This year’s Senate and House have also chosen to ignore these children.

Where did our Champions go?

Have they really forgotten about our kids that quickly?

Source: The Dome Magazine

What does fate have to do with our Personal Legend? (by Mike)

There’s an important difference between blind fate and the path of the personal legend. When we speak of fate, man’s free will is absent: we are merely puppets in the hands of a cold and distant puppeteer.
In the case of personal legend, there’s the dimension of mission. This means that the person has to actively wish to thread down the path that will enable her to flourish. It is a difficult path, there are many obstacles, but it’s the person’s choice. There is always the possibility for us to turn our backs to our personal legend.

Can the heart be wrong? (by Antonya)

How will you judge that? With your mind? If you do this, you will always find ways to discredit your heart. But these are illusions.
Think of your heart as an instrument that goes beyond the typical right and wrong views. Your heart will always be your north star in life – as long as you listen to it and give it a chance to talk to you.

If the Universe says No, sometimes more than once, to something you really want, what do you do? (by Angie)

If your wish is deep-rooted in your soul, persist. If not – the Universe is simply echoing your inner turmoil.
Always ask yourself how far are you able to go in the path of your dreams. Only when you are capable of answering that question will you be able to move forward.
But don’t forget: to enjoy the rainbow, you must also enjoy the rain

NIGHT BEFORE CHRISTMAS FOR MOMS

Twas the night before Christmas, when all thru the abode
only one creature was stirring, and she was cleaning the commode.

The children were finally sleeping, all snug in their beds,
while visions of video games flipping through their heads.

The dad was snoring in front of the TV,
with a half-constructed bicycle propped on his knee.

So only the mom heard the reindeer hooves clatter,
which made her sigh aloud, “Oh no, now what’s the matter?”

With the dripping toilet brush still clutched in her hand,
she descended the stairs, and saw the old man.

He was covered all about with ashes and soot, which fell from his hat as he gave a small shrug.
“Oh great,” muttered the mom, “Now I’ve got to clean the rug.”

“Ho-ho-ho!” cried Santa, “I’m glad you’re awake.”
“Your gift was especially difficult to make.”

“Thanks, Santa, but all I want is some quiet time alone.”
“Exactly!” he chuckled, “I’ve made you a clone.”

“A clone?” she asked, “What good is that?
Run along, Santa Claus, I’ve got no time for chit-chat.”

Then out walked the clone.The mother’s true twin.

Same hair, same eyes, and same double chin.

“She’ll cook, she’ll dust, she’ll mop every mess.

You relax, take it easy, watch The Young & Restless.”

“Fantastic!” the mom cheered.
“My dreams have come true!
“I’ll shop. I’ll read.,
I’ll sleep the whole night through!”

Then from above she heard the the youngest child fret.
“Mommy?! I scared… and I think I got wet.”
The clone replied quickly, “I’m coming, sweetheart.”
“Hey,” the mom smiled, “She really knows her part.”

The clone changed the small one, and hummed a soft tune,
as she bundled the child, in a blanket cocoon.

“You’re the best mommy ever.
“Mommy I really love you.”
The clone smiled and sighed,
“Darling I love you, too.”

With that the mom frowned and said, “Sorry, Santa, no deal.”
That’s my child’s love, that she’s trying to steal.”
Smiling wisely Santa said, “To me it is clear,”
Only one loving mother, will be needed here.”

The mom kissed her child, and tucked her in bed.
“Thank you, so much Santa, for clearing my head.”

“I sometimes forget, that it won’t be very long,
’til they’ll insist they’re too old, for my soft bedtime song.”

The clock on the mantle then started to chime.
And Santa whispered to the clone, “It works every time.”
With the clone by his side Santa said, “Goodnight.
Merry Christmas, Mom, You’ll be all right.”

~~ Author Unknown

In honor of our Sensory Friendly Family “Lights Up, Sound Down” movie this weekend – Yogi Bear – here is a great classic Yogi Bear cartoon. Enjoy ….

For details on the movie this weekend please click here.

Click here for a copy of the flyer for this weekend’s movie that you can print or share with friends (email, FB, Twtitter, or in person)