Massachusetts Advocates Seek More Coverage for Disabilities

As advocates are scrambling to ensure their cause is included in bills to widen insurance coverage in Massachusetts, it's nice to hear the voice of reason from state Sen. Karen Spilka, who happens to have a sister with Down syndrome. By providing services to children with delays now, the likelihood is they will require fewer services later in life.

Massachusetts legislators this year have filed a flurry of bills - more than 70 in all - that, if passed, would substantially expand the medical services insurers are required to cover for patients but also potentially raise health care costs.
Some legislators and insurers believe that patient advocates are racing to get their health concerns covered by law before the state’s system for paying doctors and hospitals is overhauled. A commission recommended earlier this month that the state dramatically change how providers are paid, and legislators plan to hold hearings on the issue in September.
Consider the Robies of Natick, whose 5-year-old daughter, Jordan, was born with a developmental delay that has hampered her progress in learning to walk, talk, and perform dozens of other routine activities.
One of the dozens of proposed health-related laws pending in the Legislature would make Massachusetts the third state in the nation to require insurers to cover therapies for children like Jordan, who are born with a mental or physical disability, in the same way they provide rehabilitative services to youngsters who are impaired by an illness or injury. Insurers typically pay for fewer therapy sessions for developmentally delayed children.
“If we can deliver services to children born with developmental delays and increase their functioning, we are making them more self-sufficient,’’ said Senator Karen Spilka, a Framingham Democrat. “I am not saying they won’t need any services later, but this will decrease the need for them getting government services later in life.’’