Insurance Companies Under Fire From State Lawmakers

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NASHVILLE, Tenn. - State lawmakers could start cracking down on insurance companies. They're researching a number of proposals that would force the industry to pay for services that they refuse to cover.

Lawmakers want to start putting mandates on insurance companies in certain situations. Experts and families with a stake in the issue told their story Tuesday to state lawmakers.

"If you gave him a sandwich that wasn't cut properly, he would flip out. There was a lot of time spent arranging the world, making sure our son would not flip out," said parent of autistic child Diane McNamara.

Before lawmakers the McNamara's opened up about life with an autistic child.

"It looks like he's going to go to a regular school, and he's not going to need special ed.," said McNamara.

They believe behavioral therapy was key to getting Daniel in the classroom. Insurance doesn't cover that type of autism therapy, even though some call the problem an epidemic.

"As many as one birth in 91 is going to be the birth of a child who will experience an autism spectrum disorder," said Carol Westlake, ARC of Tennessee.

Lawmakers are interested in changing how those children are covered, possibly passing mandates for insurance companies. Some admit "mandate" is a dirty word.

"That it is a word that says the government has made a determination that the citizens of Tennessee have certain needs, and that the business owners who provide some of these products have to include some of these needs in those products," said state Rep. John Deberry.

Lawmakers also learned insurance will not pay for hearing aids for deaf children.

"We need to be able to give children the gift of sound," said professor Tamala Bradham. "We know if that intervention doesn't take place, especially by six months of age, then that can have impacts on their speech."

The insurance industry is against these ideas - calling them expensive, and they warn they could lead to an increase in health care premiums. Lawmakers though are examining their own bottom line.

"We may save $10 on our health insurance premiums, but over here our school systems are paying half a million dollars on a kid that can't hear," said state Rep. Hank Fincher

When children do not get help early on with hearing loss, special education for them can cost the state $420,000. It's believed that could be avoided if insurance paid the $3,000 for a hearing aid.

Tuesday's meeting with state lawmakers was just the start of the process. They will debate these ideas more when they go back into session in January.