Autism, Managed Care, and California

A press release from Consumer Watchdog:

Autistic children with health insurance coverage regulated under the Brown administration's Department of Managed Health Care (DMHC) are routinely denied access to treatment in violation of state law while children whose policies are regulated by the Department of Insurance (DOI), led by Insurance Commissioner Dave Jones, get the care they need, according to Consumer Watchdog and parents of autistic children testifying today at a Senate hearing in Sacramento.

Consumer Watchdog said the DMHC's willingness to settle an on-going lawsuit brought by the consumer group against the DMHC under the Schwarzenegger administration will be a litmus test of whether the Brown administration is committed to caring for autistic children.

"It is simply outrageous that whether autistic children get the care they need depends on which government regulator oversees their parents' insurance company," said Jerry Flanagan, staff attorney for Consumer Watchdog. "We urge the Brown administration to reverse the Schwarzenegger-era pro-insurer policies that illegally cut off access to needed care and severely undermine the health and safety of some of the state's most vulnerable residents. Beyond the harm to severely ill children, insurers' refusal to provide treatment for autistic kids eventually leaves taxpayers to pick up the tab."

Download Consumer Watchdog's letter to Governor Brown urging him to end the Schwarzenegger-era policies:

http://www.consumerwatchdog.org/resources/autismletter3-9-11.pdf.

Beginning in March of 2009, the DMHC made a policy change to allow insurance companies it regulates to refuse to pay for an essential treatment for autism – Applied Behavioral Analysis (ABA) – on the grounds that ABA is "educational" and not "medically effective," and paradoxically on the grounds that ABA providers are not "licensed" even though no such state license exists.