Our View: Blue Shield helps autism sufferers

The tragic costs of autism are borne by us all in one way or another, but parents carry a heavier burden. The state Senate Select Committee on Autism and Related Disorders says families with an autistic child spend $40,000 to $70,000 a year on care and therapy.

But that could change. The state Department of Managed Care has reached an accord with Blue Shield by which it will begin covering the cost of services of a particular type of early intervention therapy. Anthem Blue Cross is contemplating signing the agreement. The stipulation with a key health insurance provider is welcome, but it is a stopgap. The issue must be addressed on a national level.

Blue Shield has agreed to cover treatment so long as the physician deems it is necessary, and a physician or psychologist must provide the therapy or directly supervise trained persons who give the care.

Under the agreement, the company will cover the cost of the services for six months. After that period, the company could review the progress to determine whether the therapy has helped, and whether coverage should be continued.

Until this agreement, insurance companies routinely denied coverage for the behavioral therapy, contending that it is educational, and not medical.

Senate President Pro Tem Darrell Steinberg, who chairs the select committee on autism, is carrying Senate Bill 166, which would settle the dispute by requiring that companies provide the coverage. Insurance companies are opposed, contending that the bill would add to insurance costs.

An analysis of the bill estimates its implementation might increase insurance premiums by a combined $222 million a year. But the therapy also can lower long-term costs by helping individuals live more normal lives and reduce their dependence on state services.

The federal government also is determining whether the therapy is covered under the Affordable Care Act of 2009.

While all that is being sorted out, Blue Shield has done the right thing by reaching an agreement.

Editorials are the opinion of the Merced Sun-Star editorial board. Members of the editorial board include Publisher Eric Johnston, Executive Editor Mike Tharp and Online Editor Brandon Bowers.