NY lawmakers seek coverage for autism treatments

From Newsday:

ALBANY, N.Y. - Lawmakers here and in Washington June 2 urged passage of bills requiring health insurers to pay for autism treatment and therapy for children and young adults.

A bipartisan coalition of state senators and Assembly members touted legislation from Sen. Charles Fuschillo (R-Merrick) and Assemb. Harvey Weisenberg (D-Long Beach) to have insurers cover up to $36,000 per year in autism-related care. The benefit would increase based on the inflation rate.

Meanwhile, in Washington, U.S. Sen. Kirsten Gillibrand announced plans to introduce a bill that would help military families with autistic children. She said, "They often aren't in one place for very long and that complicates health care."

In Albany, the state lawmakers criticized insurance companies that don't reimburse for treatments, leading parents to mortgage homes and drain bank accounts to pay the bills. Autism therapy can run from $20,000 to $50,000 annually.

"Parents face financial ruin or stop getting treatments for their child; that has to stop," Fuschillo said.

Autism is a neurobiological disorder affecting communication skills. The causes are in dispute and there is no cure.

One in every 150 children is afflicted, according to the advocacy group Autism Speaks. On Long Island, that amounts to 4,486 children out of a total of 672,595.

The bill in Albany would cover Applied Behavior Analysis, a treatment endorsed by the American Academy of Pediatrics and the U.S. Surgeon General. Reimbursement also would be provided for speech, occupational and physical therapies; medication; counseling; and psychiatric and psychological care.

Weisenberg said, "Ninety-percent of the families with an autistic child end in divorce. . . . We need to provide the resources so that there is less stress on these families."

Similar measures have been adopted in nine states, including Illinois, Texas and Florida.

America's Health Insurance Plans, a trade group representing companies that insure more than 200 million people, opposes the New York bill and others.

Spokeswoman Susan Pisano said additional coverage requirements would drive up premiums. She said hard-pressed employers are dropping coverage for employees because of the recession.

"They don't want to pay more for health care. . . . New mandates increase costs," Pisano said.

Some insurers have balked at paying for Applied Behavior Analysis because it has been classified as an "educational" rather than "health" treatment by the pediatrics academy.

Fuschillo and Weisenberg were cautiously optimistic that the legislation would be adopted before lawmakers end their regular session on June 22.