Progress for Autism Insurance Bills

 

The push to insure coverage for autistic children continues. Just yesterday the Kansas Senate approved the bill that would mandate coverage by a 38-2 vote and sent it to Republican Gov. Sam Brownback for his signature.

The passing of this bill comes after a six-year struggle by advocates for children with autism. If the Governor does in fact sign the bill, it will become the 34th state to require autism coverage. The terms of the bill has undergone some changes from when it was introduced last month. Whereas before it would have covered anyone under 18, it now only applies to children under 12. It requires coverage of up to 1300 hours a year for applied behavioral analysis for children up to 6 years old, eventually dropping to 520 hours a year from 6-12 years old. However, there are no age or hour limitations for other autism services.

The mandated coverage would initially apply to insurance plans before the Affordable Care Act and businesses with over 50 employees. Small employers and individuals would be covered starting in 2016. So it is still a work in progress. Democratic Senator Laura Kelley of Topeka says, “It’s a better-than-nothing-bill.” Well, having this bill on the agenda and in the public eye is definitely a good start.

Also passed yesterday was Utah’s SB57 that requires health insurance plans to provide coverage for treatment for autistic children ages 2-9. The disorder affects about 1 of every 54 kids in Utah, and parents are celebrating the progress made with the passage of this bill.

One mother of four, Erin Hansen said she had to take on an extra job just to pay for her 3 year old son’s therapy. She is excited that there will be less stress on her to provide his therapy, which has been helping him with verbal communication and helping himself with morning tasks. As every parent with an autistic child knows, these “small milestones” are huge accomplishments and great sources of joy for these families.

We hope that more bills that provide coverage will continue to go through the senate for states that don’t provide coverage. Shema Kolainu is one of the few schools in New York City that provide free services for autistic kids all over the metro area. We understand the importance of these therapies not only in the child’s life, but the parents as well. As autism month continues, we hope these issues continue to be highlighted in the local and federal political sphere.

For links to the original articles:

http://www.deseretnews.com/article/865600100/Herbert-signs-autism-insurance-bill-as-Utahns-celebrate-World-Autism-Awareness-Day.html

http://www.kansascity.com/2014/04/02/4933342/autism-coverage-mandate-goes-to.html

Health Coverage for Autistic Children

Michael Giangregorio, Vice President of Trading Services at JP Morgan has a 12-year-old son who was diagnosed with autism at 18 months old. The costs for special schooling and speech and occupational therapy can rack up to the thousands as children get older. His current employer, JP Morgan, recently announced that they will be providing comprehensive autism coverage for expensive therapies such as Applied Behavioral Analysis in its 2014 health plan.

According to a 2012 research study done by the University of Pennsylvania and the London School of Economics costs for people with autism can amount to over $1 million in treatment over their lifespan. An increasing number of major companies, such as General Motors Co., Chrysler Group, and American Express Co., are also announcing this year that they will be including at least partial coverage in their company’s healthcare plan.

Congress is also making moves to implement similar coverage policies. The House took a vote on Friday to send a bill to the Senate that would make it mandatory for insurance companies to provide coverage and treatment for children in Kansas who have been diagnosed with autism. The results were 114-3, and the bill pushes on to the Senate where they will continue the debate on this legislation.

This coverage would help many families in coping with treatment costs for their children, including roughly 1,000 children in Kansas who would be covered under the law. The bill includes guidelines on the number of hours autistic children are allotted to receive these services as well as well as age limits. Insurance companies would have to provide coverage for applied behavioral analysis for up to 25 hours per week for four years after a child is diagnosed. Once the child approaches the age of 12, the number of hours covered is lowered to 10.

Some critics of this bill argue that it is unfair to mandate specific services for their insurance to cover. They believe that this legislation interferes too much into the policies that insurance companies already have. However, legislators, such as Rep. Stan Frownfelter, a Kansas City Democrat is pushing against this criticism by saying, “I didn’t know I worked for insurance companiesWe’re here to represent the people.”

Although the future of this bill remains uncertain, we are excited to know that major companies at least have initiated and implemented this push for coverage, with stories such as Michael Giangregario paving the way. Giangregario has also voiced his support with our Director of Strategic Alliances at ICare4Autism, affiliated organization to Shema Kolainu- Hear Our Voices, in working together with industry professionals to implement positive change for autistic children.