NY passes legislation to require insurers to cover autism

From The NY Times:

ALBANY — State lawmakers passed legislation this week that would require insurers to cover autism-related screenings, diagnoses and treatments. The move was a relief for parents of children with autism spectrum disorders, but was sure to increase insurance premiums across the board.

The State Assembly passed the measure June 21, a few weeks after it passed in the Senate. The measure passed unanimously in both houses.

It now goes to Gov. David A. Paterson. New York would become the 22nd state in which insurers are required to cover autism-related treatments.

“We’ll review it once it’s delivered,” said Morgan Hook, a spokesman for the governor.

In a statement, Sheldon Silver, the Assembly speaker and a Manhattan Democrat, said, “It would be unconscionable to force New Yorkers to pay out-of-pocket for this common, chronic condition.”

There have been a variety of estimates of the effect of the legislation on insurance premiums.

“The bill sponsors acknowledge it will raise premiums up to 2 percent,” said Paul F. Macielak, the chief executive of the New York Health Plan Association, an insurance industry group, in a statement earlier this month.

“Each additional coverage requirement, while they may seem well intentioned, also carries a cost,” he said.

His group has criticized lawmakers for proposing a flurry of mandated coverage this year for things like prenatal vitamins, infant baby formula and wheelchair purchases.

“Lawmakers can’t have it both ways,” Mr. Macielak said. “It’s hypocritical for them to criticize insurance premiums as being too high and then turn around and mandate a slew of new benefits that only drive up costs.”

Peter H. Bell, an executive vice president of Autism Speaks, an advocacy group, said, “Our estimate is that it was closer to a 0.5 percent premium increase, and our experience in other states is that the increase is lower than expected.”

Mr. Bell added that the bill was more sweeping than those passed in most other states.

“It has the potential to be the most comprehensive of its kind, because other states have a dollar cap and an age cap, which means that the treatments are only available up to a certain amount of money or for specific ages,” he said. “But the bill in New York does not have those limitations.”

Statistics from the American Academy of Pediatrics, which supports the legislation, found that the autism rate among children in New York has been increasing by about 15 percent annually, now affecting close to 1 in 90 children.

“This is the next step towards making certain that individuals with autism and their families are given the appropriate insurance coverage they deserve and have earned,” said Senator Roy J. McDonald, a Saratoga County Republican who has two autistic grandchildren. “But this is only the beginning, and the state needs to do more.”