This situation keeps getting worse. No civil rights battle was won overnight, but these kids can’t wait.
Huge health insurance rate increases proposed for next year are another bitter pill to swallow for those Washington state children with disabilities unserved by the Affordable Care Act.
Hearing coverage was left out of the ACA. It is left to states to determine whether children deserve such coverage, and Washington is not among the 20 states that have passed such laws. A bipartisan state Senate bill to provide such protection was killed this year after lobbying from Washington’s dominant insurer. That insurer, coincidentally the third-largest contributor to legislative candidates, now seeks a 20 percent rate increase in the individual market — losses are mounting as healthy, younger adults fail to buy into the ACA boondoggle.
Imagine you are a child with trouble hearing. Research shows that, if your hearing disability goes untreated, you will have delays in speech and language skills; be especially challenged by complicated vocabulary; lag in academic achievement; and, quite possibly, experience growing social isolation among your peers. Academic intervention, short of treating the medical need, only adds to K-12 special education costs. Yet, in a state that doesn’t even require coverage of pediatric hearing exams, the cost of actually treating hearing impairment — namely hearing aids — may prove too prohibitive for parents.
Consider, after all, all the other costs those parents are bearing.
Even with the ACA’s much-ballyhooed “limits” on out-of-pocket expenses, parents next year could pay as much as $14,300 in up-front deductibles — on top of their premiums — to even utilize their family’s health coverage. This makes “coverage” illusory in a country where the most recent Federal Reserve Board survey shows that roughly half of citizens wouldn’t even have the cash on hand to pay an unexpected expense of as little as $400.
If your kid’s only substantive health care need is coverage for a hearing disability, thousands of dollars in deductibles get in the way of shelling out even more money to actually take care of your child. And with premiums starting to spiral out of control again your plight will get even more dire — especially if you do not have premium subsidies.
Policymakers should be embarrassed. A progressive state rhetorically boasting of “Apple Health” for kids on Medicaid treats children with disabilities like rotten apples. Only a unanimous state Supreme Court decision, for example, forced insurers to start covering autism treatment. Only newspaper headlines compelled the begrudging inclusion of Children’s Hospital in health insurance networks.
These facts are not inconsistent with federal developments. For example, the Obama Administration’s point person for ACA implementation, Marilyn Tavenner, left her post to lobby for the health insurance industry. Prior to her departure, there was not a single substantive regulatory decision regarding ACA implementation where consumer interests prevailed.
Yet surely, at least in this one instance, Washington can be as progressive as states like Arkansas, and require insurers, and the state’s own Medicaid program, to treat children with hearing disabilities like human beings whose lives have value. That could be accomplished by requiring insurers to cover hearing exams, and any necessary hardware, even if we all must pay slightly more.
Attorney Brendan Williams is a former state representative and a disabilities’ advocate. He lives in Olympia.