Tuesday, October 21, 2008

Autism Group lobbies for more insurance coverage

Autism group lobbies for more insurance coverage
By Isadora Lapowsky
Monday, October 20th 2008, 1:22 PM
At a time when an increasing number of states are requiring health insurers to pay for behavioral therapy for autism, the action group Autism Speaks is pushing for broader adoption of such coverage.

The advocacy group reportedly is campaigning to have New Jersey, Virginia and Michigan enact laws guaranteeing coverage. If they do, they would join six states (Texas, Pennsylvania, Arizona, Florida, South Carolina and Louisiana) that have recently implemented the legislation.

By the end of 2009, the group plans to push for similar action in at least 10 other states. J.P. Wieske, an insurance lobbyist, called the effort "the hottest trend in mandates we've seen in a long time. It is hard to fight them."

In New York State, policies are prohibited from excluding coverage for the diagnosis and treatment of ASD, including autism.

For many lawmakers, the personal experiences tied to the bills make it difficult to reject them. Parents tell about how well behavior therapy has worked for their children, giving certain bills nicknames like "Steven's Law" and "Ryan's Law."

Lobbying for insurance coverage has now become one of Autism Speaks' top priorities. "It's the No. 1 thing we hear from parents," said Elizabeth Emken, the organization's vice president of government relations. "What's more difficult than knowing there's an effective treatment for your children, but you can't afford to offer it to them because it's not covered by insurance?"

Researchers, however, say that therapy may only be really effective for young children. "You could make a decent case for the little kids of up to 6 or 7 that [insurance mandates] would be appropriate," said Tristram Smith of the University of Rochester Medical Center in New York. Smith, who co-wrote a study on autistic children in 2000, said, "It would be hard to make that case for older kids."

Despite opposition, Autism Speaks is continuing its drive with extra force in this election year. Recent economic bailout measures approved by Congress included a requirement that health insurance companies provide equal coverage, in general, for physical and mental health. Though that does not always include people with autism, Emken sees the law as a good sign.

"We hope it sets the stage for the Congress and the next President to continue this effort to end discrimination in the health insurance marketplace," she said. "Whichever party is elected, autism will be on the table and be a major point of discussion. There may have to be a federal mandate."

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