Of Red Herrings and Pink Elephants

The Chicken Littles were out in force recently at the state Capitol. One after another, they traipsed before a House committee to warn of cataclysmic consequences if voters approve SQ 744, the Oklahoma Education Association-sponsored initiative that would require lawmakers to fund public schools at the regional average.

It was a made-for-TV drama, which was produced and directed by Republican legislative leaders who -- for the most part -- despise the OEA, the state's largest teachers' union and the driving force behind the collection of 240,000 voter signatures that ensured the initiative appears on next year's general election ballot.

Lawmakers didn't need to have staged two days of sky-is-falling hearings. They already knew the abysmal revenue and budget numbers and the potential impact of SQ 744. The truth is: They summoned agencies from across state government to wail publicly about possible layoffs and service cuts as a preemptive strike against the initiative, fearing its passage will strengthen and embolden the OEA.

Actually, the legislative leadership's focus on SQ 744, also known as the HOPE -- Helping Oklahoma Public Education -- initiative, is quite revealing. Their No. 1 priority: Amassing and maintaining political power.

If it weren't so, they would be staging public hearings, and engaging in vigorous public debate, on an issue that threatens to dwarf the $850 million they claim the HOPE initiative would cost the state.

The pink elephant under the Capitol dome? Autism.

For more than three years, parents of children with autism have lobbied state lawmakers -- unsuccessfully -- to require insurance companies to cover treatment. Insurers, and their legislative allies, insist the costs would be back-breaking. Meanwhile, families across Oklahoma are going bankrupt as they scrape together every last penny for treatment that gives their autistic children a fighting chance at a productive adulthood.

How does this impact the state budget?

In Oklahoma, about 500 children are diagnosed with autism each year. Eventually, they will become adults, many eligible at age 18 for government aid ranging from Social Security-related benefits to Medicaid. Their life expectancy is the same as those without autism, and recent studies indicate it costs about $3.25 million to care for autistic adults, not including housing.

Federal and state governments will share the burden, but it's not difficult to imagine -- given that 1 in 100 children are now being diagnosed with the disease -- that autism could end up costing Oklahoma taxpayers in excess of $1.5 billion a year or about one-fourth of the entire state budget.

Eighty percent of the Oklahoma children already diagnosed with autism are younger than 16, meaning a perfect storm could be brewing: The oldest will be reaching adulthood at about the same time as Baby Boomers begin tapping Social Security and government health care programs.

"The first big wave is coming at us," said Edmond's Wayne Rohde, whose 11-year-old son Nick suffers from autism.

This is classic cost-shifting. Insurance companies calculate it's less expensive to pour thousands of dollars into the campaign accounts of sympathetic lawmakers -- those who will oppose any new coverage mandates -- than it is to cover autism, even though they'd probably just raise premiums to protect the bottom line anyway. Moreover, why would an insurance company willingly provide coverage for anything when the taxpayers are eventually on the hook?

It won't make any difference to the current crop of legislative leaders who are all-too-happy to do Big Insurance's bidding.

This is a serious public policy matter -- Oklahoma's version of the health insurance reform debate in Washington. The Legislature hasn't approved an insurance mandate since Republicans took control of the House of Representatives in 2004. The last mandate? Insurers were required to cover annual mammograms for women.

The conventional wisdom is that efforts to force insurance companies to cover autism are a strictly partisan dispute: Democrats support the mandate, Republicans oppose it. The reality is different: The GOP leadership is hooked on campaign contributions from the insurance industry, and it uses the money as a hammer to keep legislative Republicans in lock-step on the issue.

It's clear, however, that GOP leaders are less-than-confident what would happen if the measure reached the floor of either house for a straight up-or-down vote. They're not taking any chances. In fact, House Republicans this year killed the measure in committee where fewer votes needed to be controlled to ensure the outcome.

Whether the mandate can be revived next year depends in part on the parliamentary kills of minority Democrats. More importantly, it depends on the willingness of enough Republicans to recognize that sound public policy. It will cost much less to invest in childhood treatment than it will to, in effect, warehouse thousands of autistic adults.

Fifteen states already have recognized the wisdom of this strategy. They know there is scant evidence that mandating insurance coverage for autistic children will significantly increase premiums or the number of uninsured. What it does is protect families from bankruptcy and taxpayers from an unnecessary burden.

And it ensures that thousands of lives won't be wasted: According to studies, half the children that receive early, aggressive and consistent intervention have most of their symptoms erased by grade school age. Further, many won't end up needing to be placed in special education classes.

Pay now or pay later.

-- Arnold Hamilton is editor of The Oklahoma Observer www.okobserver.net