At that time, 63 percent of private-sector workers in Oklahoma were enrolled in an employer's self-insured plan. Those plans are exempt from state insurance mandates under federal law. When that group was combined with the uninsured, the Bouder study estimated up to 70 percent of Oklahomans with autism would get no benefit from a mandate. Of the remaining 30 percent, the Bouder study estimated only about one-third would actually seek treatment. The study then assumed those seeking treatment would use just 30 percent of the proposed $75,000 annual benefit, on average.
In other words, the study noted few would receive the benefit, then predicted those who did would largely ignore it and those who used it would not use it much. Lawmakers were understandably skeptical.
Instead, they pursued other proposals providing broader benefit to those with autism. Lawmakers increased in-state training for behavioral therapists. They provided scholarships to children with autism, allowing those kids to attend schools designed to maximize benefits for that population. Today, the positive result of these efforts is undeniable.
As understanding of autism grows, treatments undoubtedly will improve and insurance will increasingly cover them. This doesn't mean Oklahoma lawmakers were wrong to hold off on an autism mandate. When even the fiscally profligate Obama administration worries that open-ended autism coverage might be a budget buster, Oklahoma Republicans' caution was clearly justified.