HR0474 95TH GENERAL ASSEMBLY

HR0474 LRB095 12292 KBJ 36869 r

HOUSE RESOLUTION

WHEREAS, Many families face substantial hardship when a child in that family suffers from a brain disorder that is congenital or acquired at a young age; and

WHEREAS, These disorders are sometimes known at birth, but sometimes are not diagnosed until later in infancy, childhood, or adolescence when an expected level of function does not appear at the expected age it should; and

WHEREAS, These disorders can include, among others, Down syndrome, cerebral palsy, and disorders within the autism spectrum; and

WHEREAS, These children are likely to benefit from habilitative care as prescribed by a physician, including occupational, physical, speech, and language therapy; and

WHEREAS, In Illinois today, insurance companies typically provide coverage for restorative or rehabilitative therapy for children who, having had the ability to walk and talk, lose those skills in a car accident or from a devastating disease, such as meningitis; and

WHEREAS, The identical services are denied coverage by many insurance companies when, as opposed to rehabilitative services to restore a lost skill, the services are habilitative, to develop new skills; and

WHEREAS, Providing insurance coverage for rehabilitative therapy to regain a lost skill is of no greater importance than providing insurance coverage for habilitative therapy to develop a new skill and this unequal treatment of similarly situated children and families is arbitrary and unfairly discriminates against children with identical needs; and

WHEREAS, The practice of denying insurance coverage for habilitative services discriminates against children with neurological impairments, because the vast majority of these children have congenital brain disorders, necessitating habilitative therapies, and is contrary to the ideals of our society which values access to medical care of all patients with similar conditions; and

WHEREAS, The State of Illinois already recognizes the wrongful nature of this discrimination by meeting its obligations to provide habilitative services in the Covering ALL KIDS Health Insurance Program; and

WHEREAS, In the State of Maryland, similar discrimination was resolved by the passage of a law mandating insurance coverage for habilitative services; the economic impact of that law was considered by the Maryland Health Care Commission, which reported in 2006 that the mandate for insurance coverage of children's habilitative services amounted to only $5 of the annual cost of a group insurance policy, or 0.1% of the annual premium, and only $2 of the annual premium as a marginal cost (cost of the benefit minus the value of services covered were there no mandate); therefore, be it

RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE NINETY-FIFTH GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that we urge the Division of Insurance of the Department of Financial and Professional Regulation and the Department of Human Services, in consultation with insurance companies, support groups for children in need of habilitative services, and medical practitioners specializing in the care of children to undertake a study of this disparate treatment of Illinois children and investigate: (1) the insurance treatment for habilitative services by insurance companies doing business in Illinois; and (2) the potential costs to premium holders by mandating the coverage of habilitative care, and also the cost savings of such a mandate, both societal and as an impact upon reducing costs to the Covering ALL KIDS Health Insurance Program; and be it further

RESOLVED, That suitable copies of this resolution be delivered to the Governor, the Secretary of Human Services, the Secretary of Financial and Professional Regulation, the Director of Insurance, and the Attorney General.