Jon Ralston sees cruel irony in exclusions from autism coverage bill

By Jon Ralston

Friday, April 24, 2009 | 2:02 a.m.

As I was telling a friend the other day, I want to believe.

I want to believe that despite the collection of irredeemable nincompoops, borderline criminals and self-interested cowards, some legislators actually want to be thoughtful and responsible in dealing with the state’s budget problems. I want to be believe that some of the term-limited folks don’t see the end as simply a new beginning to search for other elective jobs. I want to believe that there are leaders in the capital who see beyond the numbers games, the right- and left-wing shibboleths and the external forces and won’t set the bar as low as simply performing better than The Man Formerly Known as Governor.

I want to believe, but then I open my eyes. And there it is — the legislative “process” that somehow allows inane measures to escape such as that silliness about disposing of the Electoral College or one assemblyman’s bill (and I am sure there are more) that will directly benefit a company that employs him.

You can always find those abominations. But if anything reinforces that I gotta believe this group is nothing akin to the Amazin’ Mets, it is the Assembly’s passage of what ostensibly was a landmark bill to cover autism treatments but what actually is emblematic of a state that shoots low and so often gets there.

This is the legislative “process” at its best and worst, an example of good intentions partially realized but ultimately thwarted by a belief that something is better than nothing.

Assembly Bill 162, which passed the Assembly this week with only two dissenters, would for the first time mandate that insurance companies cover early intervention treatments for children diagnosed with autism. The disease, which some research shows affects 1 in 150 children, can bankrupt parents who cannot afford the expensive treatments, which if given early can make dramatic differences in the quality of their children’s lives.

The scene in the hallway Wednesday after the measure passed the Assembly was one of rare, authentic emotion, as parents and their autistic children wept with joy, a human face so often lost in the torrent of bills passed every session.

“This is a huge victory, not only for families, but for all Nevadans,” Speaker Barbara Buckley told reporters. A national autism organization even applauded from New York City.

But while this exultation may be understandable, it ignores the tragic fact that because of concerns over cost, hundreds, perhaps thousands, of families with autistic children were carved out of the bill, including some of the ones least able to afford treatment — state employees and Medicaid recipients.

The bill thus has an Orwellian effect — all autistic children are equal but some are more equal than others.

This rankled one of the body’s most conservative members, Republican James Settelmeyer of Gardnerville, who rose on the floor to lament, despite his support for the bill’s concept, “I felt that the state should not be treating its employees any differently. Their children with autism count, as well.”

Assemblywoman Sheila Leslie, a longtime advocate for the less fortunate, rose to defend the measure: “I think the question is whether, if we cannot help all of the kids, we should help some of the kids. The bill that you have before you today helps more than a few children. It’s the start. We need to cover autism for the state employees’ children, for our residents who are on Medicaid. Every child should have access to this treatment.”

Indeed, either every child should have access to the treatment or none should. If you want to have a debate over insurance mandates and whether this is appropriate, fine. But that’s not the reason for creating this capricious caste system simply to buckle to questions of cost.

I understand the argument of supporters that this is a nose under the tent for coverage. But that is philosophically unsustainable and the proverbial tent here is very small and unlikely to ever allow anything more than a sniff of progressive policy.

How fitting in a session that has demonized state employees and promises to cut their salaries and benefits that they also should be deprived of this landmark coverage. How fitting in a state where getting to the national average in education funding is the holy grail that the bar is set so low here, too. How fitting during a session where economic and political realities will erase bold strokes on taxing and spending policies in favor of incremental half-measures — like the autism bill.

I want to believe. But they make it so hard.

Jon Ralston hosts the news discussion program “Face to Face With Jon Ralston” on Las Vegas ONE and publishes the daily e-mail newsletter “RalstonFlash.com.” His column for the Las Vegas Sun appears Sunday, Wednesday and Friday. Ralston can be reached at 870-7997 or at [email protected].