Bill requiring health-insurance coverage for autism goes to governor

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The Assembly gave final passage last night to legislation that would require accident and health-insurance policies to provide lifetime coverage for screening, diagnosis and treatment of autism spectrum disorders, regardless of the cost of treatment or age of the patient. The Senate approved the legislation last week, so it now goes to Gov. David Paterson for his consideration.

Policies would have to cover clinically proven, non-experimental treatments. Many plans currently do not cover screenings and treatment for autism, which means families often have to pay for costly health-care bills.

Autism is a brain disorder that affects social interaction and communication. Some children engage in repetitive behaviors. The number of children estimated to have autism has been increasing steadily. The most recent estimate by the federal Centers for Disease Control and Prevention is that one in every 110 children in the United States has autism spectrum disorder. In New York, studies have found that nearly one in every 90 children has autism, according to the sponsors of the state legislation — Sen. Neil Breslin, D-Delmar, Albany County, and Assemblyman Joseph Morelle, D-Irondequoit, Monroe County.

Early intervention has been found to be the most successful way of helping children with autism.

Health-insurance providers, which have opposed the legislation, said it lead to an overall hike in insurance premiums. The state Insurance Department estimates the increases would range between 1 percent and 2 percent. The New York Health Plan Association, which represents managed-care plans, believes that estimate is on the low side, Leslie Moran, the organization’s senior vice president, has said.

If the governor signs the legislation, the state health commissioner, in consultation with the commissioners of the Office of Mental Health and Office of Mental Retardation and Developmental Disabilities, will identify minimum coverage options for evidence-based and clinically proven treatment and therapy.

“Reliable health insurance coverage for autistic children is long overdue.  Parents and youngsters have suffered with uncertainty for too long,” Morelle said in a statement.  “No longer will parents have to guess what medical treatments their insurance carrier will or will not cover.  This bill would give families peace of mind, allowing them to confidently seek the medical care their autistic child needs.”

Assembly Speaker Sheldon Silver, D-Manhattan, said in a statement that it would be “unconscionable” to make families pay out of pocket. “Some studies have indicated that the annual cost of treatment can be as high as $72,000 a year.  Current law is written so that ASD coverage is ‘not excluded’ in accident and health insurance policies, but we needed to make clarifications and ensure that families are able to get the best options available to treat this serious developmental disorder,” he said.

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  1. Videos titled, “Autistic Adult in Crisis Goes Unnoticed” and “Shocking Patient Neglect of Autistic Person” on youtube warrant immediate attention to dangers of managed care and general hospital medical mismanagement of severely autistic patients in California. What we witness here is a FAILURE to care, as in from the heart. There is little intrinsic motivation for many nurses, doctors to really HELP their patients, especially complex ones that require complex care management. So do we need healthcare reform? DO we really need to change a system, when the real problem is heart care reform? As in value, dignity and respect for persons with special needs, the elderly, sick, infirmed, disabled, blind lame? WHERE are the miracle workers of today? Where are those that go the extra mile to help patients?

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