Missouri governor, legislators say they will make sure autism treatments covered by insurance

From The News Leader in Springfield, Mo.:

After picking up donated food for her family, Elizabeth Obrey (pictured) made a stop Thursday that made her cry.

The Springfield mother, who has two children with autism, used a tissue to dab her eyes after hearing Gov. Jay Nixon and state legislators say they were determined to make those with autism eligible for insurance coverage for the treatment they need.

During an announcement at the Burrell Autism Center, the governor and lawmakers said they will sponsor bills to make sure insurance companies cover "evidence-based" treatment for people with autism -- specifically, what's called Applied Behavioral Analysis treatment.

"Autism spectrum disorders are touching the lives of more and more children every day," he said of a range of disorders that affect an individual's ability to think, feel, speak and relate to others.

Nixon said at least one bill that would have required companies to provide this type of coverage wasn't approved during the legislative session, but the first bills pre-filed in the state House and Senate are already receiving widespread report. The new session starts Jan. 6.

"Unfortunately, that bill didn't make it across the finish line, but these bills will," he said.

Obrey said, if approved, such insurance coverage will save her family financially.

They rely on donated food and other help -- including financial help from relatives to pay for treatment.

"This is very emotional; it's huge," she said after Nixon and lawmakers announced the push for passage of insurance coverage. "It means they will get what they need, and we will be able to regain some of our life."

Nixon said new statistics indicate one in 100 newborns are diagnosed with some form of autism, yet insurance companies refuse to cover the treatment those children need.

Sponsors in the state Senate include Sens. Scott Rupp, R-Wentzville, and Eric Schmitt, R-Glendale. The state House sponsor is Rep. Dwight Scharnhorst, R-Manchester.

Rupp said insurance companies should not be able to tell parents of children with autism that the treatment isn't covered.

"We're just going to right that wrong," he said. "We're going to say 'Yes, it is your responsibility.'"

If passed, the bills also would require coverage up to $72,000 a year for treatment and not limit the number of visits for treatment.

The proposed legislation would not allow insurance companies to refuse to renew, end or restrict coverage solely because an individual is diagnosed with autism.

Crystal Hays of Ozark said she and her husband initially were unable to pay for ABA treatments costing up to $4,000 a month for her son, Caleb, and opted for getting only part of the treatment their son needed.

According to Autism Speaks, ABA is a customized treatment that starts with observing a person's behavior and then using positive reinforcement, communication, direct instruction and other techniques to help that individual function as independently and as successfully as possible.

Therapy using ABA that involves repetitive training is effective when used early in a child's life, Hays said.

"In a month, I saw a difference," she said of Caleb, now age 6. "In six months, my son looked at me and for the first time said he loved me."

While her husband's parents provided the money needed for additional treatment, Hays said she knows families who lost homes to foreclosure because insurance wouldn't cover such treatment.

Requiring insurance companies to pay for therapy will ease the financial burden and allow therapy providers to help more people, said Susan Henderson, director of the Burrell Autism Center.

After the news conference, Henderson said that while there is some controversy about experimental treatments for those with autism, the bills' sponsors have defined what insurance will cover.

She said that by using the term "evidence-based," the sponsors sought to avoid controversy about whether experimental treatment can be covered.