Wednesday, 17 March 2010

• Federal Autism Coverage Madate: WE NEED IT

  For those of you who do not have a child with autism, ask yourself "what would I do if my child was diagnosed with Autism Spectrum Disorder"?  Most of you would seek treatment - as soon as possible.  Most of you would want the best and most effective, scientifically-proven method of treatment for your child.  And some of you would seek alternative treatments - any means of possibly "curing" your child of this disorder. A disorder so few people know anything about.
  
  
  But most of you would find out that ANY treatment for autism is very expensive, difficult to obtain and not covered by insurance companies. 
  
  In some states, autism treatment and diagnosis must be covered by health insurance providers.  However, the terms in which it is covered is very vague.  For instance, in my state of New Jersey, autism treatment up to $36,000 per year must be covered by private insurance policies bought in New Jersey.  If you work for a large company that has it's own insurance policy, this law is not applicable.  If you work in New York or another state that does not have mandatory insurance coverage and you live in New Jersey, it is not applicable.  If you are one of the lucky ones (like us) that have a policy bought in New Jersey, you are covered, however there is no clarification in the mandate which defines co-pays, in/out of network practitioners or deductibles.    So I can take Ava for therapy and be charged a $50 co-pay per session as outlined in my policy.  If she needs 25 hours a week, that is $1250 per week.  And most practitioners do not take insurance so a family will have to pay the provider up front and then wait to be reimbursed, if they are reimbursed.
  
  There is currently a bill in the U.S. Senate and House for comprehensive autism legislation, including a section addressing broad based federal autism insurance reform.  We can thank Representatives Mike Doyle (D-PA), Chris Smith (R-NJ), Eliot Engel (D-NY), and Hank Johnson (D-GA) and Senators Richard Durbin (D-IL), Senator Robert Casey (D-PA) and Senator Robert Menendez (D-NJ) for introducing this legislation.  Whether you stand on the right or left side of the aisle, you cannot deny that the autism population is growing -- 1 out of 110 children are diagnosed with autism.
  
  The “Autism Treatment Acceleration Act of 2009” (ATAA) contains a total of twelve sections, each putting forth a different program for autism.  Section 12 of the bill has the provisions for federal reform of autism insurance coverage.  If passed, it will require all insurance companies across the country to provide coverage for evidence-based, medically-necessary autism treatments and therapies.
  
  Once we have this insurance coverage, making it affordable for families to have their children treated, we have to make a national effort to treat autism.  We need more practitioners, trained therapists and mandatory screenings for children under 2.  We need more education and public awareness.  It is sad that most people have no idea what autism is, or what to look for until their child is diagnosed.
  
  I urge you to contact you senators and representatives, urging them to support ATAA.  We need treatment for our children - and whether you are wealthy, middle class or poor, the costs involved in treatment are exorbitant and difficult to acquire.

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