Even with mandatory autism insurance coverage in Wisconsin, some families still struggle to pay for treatments

From Channel 3000.com:

MADISON, Wis. -- After years of debate, state lawmakers passed mandatory autism insurance coverage in June, but some families are now finding out they're still left in the cold and with some big bills as their children need more help.

The new state insurance requirement was thought to be one cure for those with autism. The condition is a broad spectrum neurological disorder the U.S. Centers for Disease Control and Prevention said afflicts one in every 110 children.

Many Wisconsin families said that they're learning the new help is no help at all, WISC-TV reported.

Alex Tarnutzer, 5, has good days and bad days. His higher functioning form of autism, called Asperger's syndrome, means one minute he can play quietly with his dad and the next meltdown into a potentially dangerous outburst.

"He'll kick, he'll scream, he'll throw. It's just completely uncontrollable anger," said his mother, Renee Tarnutzer.

Parents Renee and Troy Tarnutzer, who are both full-time workers, last year spent $17,000 on therapy for their son, but they said they know he needs more to control aggression that poses risks to him and others and cope with a sensory processing disorder that makes him shutdown in chaotic situations.

"We still haven't done the intensive intervention sort of services. Those cost between $40,000 and $50,000 a year," Renee Tarnutzer said.

So, like so many others, the couple cheered when the state earlier passed mandatory insurance coverage of autism treatment earlier this year.

Now the only problem is, they're not covered. The law applies only to state-regulated insurance companies. Their employer-based one, AETNA, is federally regulated and when the Tarnutzers tried to buy state-based insurance, numerous companies denied them, citing Alex's pre-existing condition.

They are among many families who are still falling through the cracks, WISC-TV reported.

"Everyone in governmental power needs to start taking a look at how they can fill that crack. Because these kids need help and they need help now," she said.

State Rep. Scott Newcomer, R-Pewaukee, voted against the mandate. He said he wanted the state to fully fund its current Medicaid autism program that serves such families. There's still a waiting list for that program.

"You're talking at least half the people, if not up to 70 percent of the people, will not have coverage under this program and I mean that's just crazy!" he said. "We need to fund all of these families. The insurance mandate -- all it did was fund a few of the families and increase the cost."

Newcomer said a special session for a budget repair bill might be necessary. If so, he said he promises to push for that program funding. He said it's cost effective and that the state can afford it.