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Areva Martin

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Is Obamacare What the Doctor Ordered for Kids with Autism?

Posted: 10/01/2013 5:38 pm

On Oct. 1, our nation's health care system will experience significant changes -- changes that many are still debating and questioning. While Sen. Ted Cruz, R-Texas, wasted his constituents' time grandstanding in hopes of thwarting implementation of the Affordable Care Act (ACA), millions of deserving Americans are preparing to have greater access to affordable health care -- access they never had before.

Despite the political wrangling over the ACA, commonly referred to as Obamacare, undeniably it is a game changer. An estimated 14 million people will access health care through a system of exchanges run by states and the federal government. Most people signing up for health care will get subsidies based on income and family size.

This means low-income families, including those with disabilities and special needs, will have more health care insurance and program options. Rather than traditionally depending on emergency rooms as primary care providers and straining over-burdened health care centers around the country, these families will be able to purchase low-cost health care coverage and access much needed wellness and rehabilitative programs thereby alleviating excessive hospital visits. Through several states' exchanges, premiums will cost as low as $100.

As an advocate for special needs children, I'm particularly impressed with the aspects of Obamacare that benefit special needs children. Under the new law, children are allowed to remain on their parents' health insurance plan until age 26, closing an antiquated coverage gap that has plagued families for decades.

Also, children with pre-existing conditions will not be turned away, and for the first time for many families, wellness checks will be a covered cost. This will allow providers the opportunity to better manage the overall health of families, and with children in particular, this can alleviate common childhood illnesses that cause a disruption in school attendance and lead to long-term conditions such as diabetes and hypertension.

With an emphasis on accessing health care through community clinics, Obamacare eliminates transportation barriers that have traditionally made it difficult for low-income families and those with chronically ill or disabled children from accessing health care. In communities like South Los Angeles that has 43 percent fewer health care resources than its more affluent neighbors in West Los Angeles, the community clinic component of the new health care law should inspire the kind of investment in health care centers that the community has desperately needed.

But with all of Obamacare's positives, families of autistic children who rely on Medicaid still have hurdles to overcome. In the last two decades, there has been a dramatic increase in the number of individuals diagnosed with Autism Spectrum Disorders (ASD) across the country. Now one in 50 school-aged children are impacted. According to the American Academy of Pediatrics, ASDs are lifelong neurological developmental disabilities that profoundly affect the way a person comprehends, communicates and relates to others. It is well established that early intervention services for young children with ASD significantly improve children's prognosis and should begin as early as 18 months of age. Further, research indicates that one-third of children receiving early intervention services improved so much that their need for ongoing support was dramatically reduced.

Along with the benefits to the children, early intervention saves states millions of dollars as reports show that many individuals with ASD require lifelong supports at a cost estimated at $3.2 million per person. Early intervention can reduce those costs by more than half over an individual's life span. Yet only nine states will extend Medicaid to include autism therapies.

Given the research and recommendations by the nation's leading pediatricians, the majority of states are not following the doctors' orders. Children with autism need more, deserve more and are counting on all of us to ensure they get more. It's unthinkable that kids whose families are at the lowest end of the socio-economic ladder and who suffer from a lifelong disorder for which there is no known cure or cause have to forego the only medical treatment proven to improve their condition. Could you imagine a law that made chemotherapy unavailable to kids on Medicaid who have leukemia or insulin to those with diabetes? Of course not.

Likewise, kids with autism who receive Medicaid should not be denied access to autism therapies. If health care is truly a right and not a privilege, it cannot be confined to the few, but rather must be made widely available to all families. Making this happen will require more than grandstanding by senators on the floor of the U.S. Senate. It requires progressive legislators who will stand up in state houses around this nation and fight for comprehensive care for kids with autism not only because it will save states millions of dollars, but because it's what the doctor ordered.

 

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