Autism Speaks today formally endorsed SB.57, the latest piece of legislation to require certain health plans in Utah, the state with the highest prevalence of autism in the nation, to cover medically necessary treatments.
Utah is one of just 16 remaining states yet to enact autism insurance reform, having instead created a "lottery" under its Medicaid program in which several hundred of the state's estimated 18,000 children with autism are randomly chosen for treatment. The 2014 bill is again sponsored by Dr. Brian Shiozawa, a Salt Lake Republican Senator and past president of the Utah Medical Association.
SB.57 would require state-regulated health plans to cover applied behavior analysis (ABA) up to $36,000 a year for children through age 8, then up to $18,000 a year though age 17. The new bill mirrors a coverage plan Salt Lake Mayor Ben McAdams proposed for county employees in his 2014 budget proposal.
Small businesses with fewer than 50 employees would be exempt from providing the coverage if they could demonstrate it raised the cost of their health plans by 2.5 percent or more. A new study in Missouri showed the impact of its autism insurance reform law during 2013 on total health care costs was 0.2 percent.Also at Autism Speaks, Andrea Griggs of Murray, Utah, explains what it took to pay the bills for her son Jaxon:
We were faced with tens of thousands of dollars in bills for the first year of his treatment that our insurance company wouldn’t pay a single dime to cover. We went through our entire savings, but still couldn’t afford to pay for his treatments. After much thought and prayer, we came to a very difficult decision for our family. The only way we would be able to give Jaxon the treatments and opportunities that he would need to be happy and successful was to sell our home.
This was not an easy decision for our family to make. We had built this home together from the ground up. We had moved there before our oldest started kindergarten so they would attend the same school with the same kids all through elementary school and even through high school. We had made friends and established a neighborhood family that we all loved. Change is difficult for anyone, but even more so for an individual with autism. This was a very difficult decision for our family.