Traverse City Record-Eagle

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February 24, 2013

Lt. Governor leads battle for insurance coverage

TRAVERSE CITY — Brian Calley immersed himself in an effort to get autism insurance coverage mandated, even before his own daughter was diagnosed as autistic.

Calley, Michigan’s lieutenant governor, launched his effort during his freshman year as a state lawmaker, when his daughter Reagan was a newborn.

“Over the course of the last decade especially, awareness or the prevalence of autism has risen,” Calley said. “The reaction by the traditional insurance industry has been to essentially bar any coverage for any service at all, even in some instances where you have behavioral therapy, for example. If you read your policy, you’d say, ‘Well, my policy covers behavioral therapy.’ You’d find out they cover it for everything except autism. There really was a systematic exclusion from all insurance, pretty remarkable how complete it was, to the point that a change in the insurance code was necessary to reverse that trend.”

Autism insurance reform failed with each legislative proposal, but seemed to progress, inch-by-inch with every attempt. Calley, a Republican, finally pushed through legislation about a year ago. Reagan is now 6.

Behavior, occupational and speech therapies are now mandatory, but that does not include the round-the-clock institutionalized therapy needed by patients like 13-year-old Issy Stapleton, of Elberta.

The state’s new law also only applies to those under 18 and in the “normal” spectrum of autism, Calley said. That means mild cases are not included, and neither are severe cases like Issy’s. Calley hopes to address institutional care in future legislative efforts; he hopes to include all mental health issues, not just autism.

“That, unfortunately, is beyond the scope of the mandate,” Calley said of Issy’s predicament. “That’s one of the areas I’ll be focusing on in the next year, identifying the gaps as they exist today. We’ve got a ways to go, across the board.”

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