Autism bill shows how politics can trump policy

By J. Patrick Coolican

Sunday, April 12, 2009 | 2 a.m.

A bill forcing some private insurance companies to cover treatment of autistic children won an Assembly committee’s approval last week, and it’s almost certainly on its way to becoming law.

Here’s one reason: Republicans and conservative Democrats won’t likely stand in the way even though they are philosophically opposed to mandating this type of coverage because they think it drives up costs.

Why let it pass?

A Republican operative offered a reminder: Dr. Joe Heck.

Heck is a former Republican state senator beaten in 2008 by a little-known challenger, Shirley Breeden.

Democrats ran a vicious and well-funded campaign against Heck.

Mailboxes filled with glossy mailings that said Heck, a physician, voted against requiring insurance companies to include cervical cancer screenings in their basic coverage, even as he accepted campaign donations from insurance companies.

“Dr. Joe Heck took money from insurance lobbyists and voted ‘no’ to cervical cancer screenings,” one ad said.

The ads featured photos of women in cancer wards.

Classy.

The ads weren’t even really true. Insurance companies have been required by the state to cover screenings for cervical cancer since 1989. The ads seemed to refer to legislation from 2007, when the Legislature passed a law requiring some insurance companies to cover Gardasil, the vaccine for the human papilloma virus, a precursor of cervical cancer.

But the point still holds. An elected representative who chooses an insurance company over a sick woman or a child with autism is finished.

Still, opponents of these mandates say they’re bad policy.

Insurance companies have traditionally declined to pay for autism treatment, which usually involves intensive speech and occupational therapy. They assert that the care is not strictly medical even though it arises from a medical condition.

The mandate will increase the price of insurance for everyone else by about 1 percent.

The insurance industry notes the mandates would not apply to as many as 40 percent of plans in Nevada because they fall outside the purview of state regulation and thus can ignore the mandates.

More broadly, opponents argue, why should the extraordinary burden of treating autistic children — $24,000 to $40,000 per child per year — be so concentrated on so few people?

If treating autistic children is a social good, the cost could be shared by taxpayers. But what politician would suggest a tax increase when he could just put it on the insurance companies?

This type of thing enrages one insurance lobbyist, who was granted anonymity to speak freely about legislators.

He pointed to another reason lawmakers don’t want to oppose the bill: They have to sit in a committee room loaded with inspiring families who have heartbreaking stories about being denied therapy for their autistic children.

What monster could say no to these children?

When you add it up — vicious campaigns, heartbreaking stories of woe, easy and evasive solutions — you have a legislative process that has become beholden to politics rather than policy.

Or, maybe the insurance lobbyist is just an old-timer embittered that the influence and prestige of power lobbyists is on the wane as the public helps craft policy through the messy vehicle of democratic politics.

Sun reporter David McGrath Schwartz contributed to this story.