Nov 14, 2008 3:32 pm US/Eastern
Parents Push States For Autism Insurance Laws
BOSTON (WBZ) ―
Behavioral therapy is the most proven method to help kids with autism develop the skills they will need to live more independent lives.
The treatment costs tens of thousands of dollars a year, but most health insurance plans don't cover it, forcing many parents to foot the bill. One advocacy group is teaming up with parents and state lawmakers to change that.
Ben Walsh is learning a valuable lesson. His parents started him on behavioral therapy after he was diagnosed with autism eight years ago.
Mary Beth Walsh explains, "Kids with autism don't learn things naturally. They don't learn by watching other people or by imitation. All skills really, have to be taught very specifically and broken down."
But as Ben's parents quickly found out, most health insurance plans don't cover applied behavioral analysis therapy, or ABA, which can cost upwards of $50,000 a year.
"We took out a second mortgage on our house. We ran through our savings. We borrowed from relatives," Walsh said.
The advocacy group Autism Speaks is working to change that.
Members helped pass legislation in seven states to get insurance companies to cover what they call medical treatment prescribed by doctors.
Peter Bell, Executive Vice President for Programs and Services at Autism Speaks, says, "We're very focused on trying to, state by state, enact legislation that requires Insurance companies to cover medically necessary, evidence based treatments for autism."
But the insurance industry argues the therapy is educational so schools should pay for it.
"These services are being transferred to the healthcare system at a time when those we serve are telling us they cannot afford to pay more," Susan Pisano, communication vice president for America's Health Insurance Plans.
Ben's parents eventually found a public school program that provides ABA therapy in class and at home, but he is one of the lucky ones.
Walsh says, "We have 20 children in our school and a waiting list of hundreds."
And with 67 children diagnosed every day with autism, the number of kids who are going to need help to become self-sufficient is growing.
Massachusetts currently does not have a law in place requiring private insurance companies to cover autism services.
Learn more about Autism Speaks State insurance initiatives
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