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Saturday, March 18, 2017

Insurance and Medicaid, March 2017

The Politics of Autism includes an extensive discussion of insurance and  Medicaid services for people with intellectual and developmental disabilities

Brianne Pfannenstiel  reports at the Des Moines Register:
The Iowa House of Representatives voted unanimously Wednesday to require that insurance companies cover a treatment for autism that parents say can help provide a better quality of life for their kids.
"Our oldest daughter is autistic," said Rep. Andy McKean, R-Anamosa. "And I can simply say that my wife and I would have very much wished that this legislation was in effect back many years ago."
House File 215 would require insurance companies to cover applied behavior analysis for children with autism if they're issuing health plans to companies with more than 50 employees, or for plans to public non-state employees. Coverage would become available for families with dependents younger than 19 who have been diagnosed with autism spectrum disorder.
Madeleine Hackett  reports at WTVY, Dothan, Alabama:
50,000 families in the Yellowhammer state are affected by autism, yet Alabama is one of only five states that does not require insurance companies to pay for certain treatments.

House Bill 284 is hoping to change that.
It would require private insurers to include coverage of "Applied Behavioral Analysis" (ABA) treatment.
As it stands, families must pay out of pocket for these costly therapy sessions.
It would also require treatments for things like speech and occupational therapy to be covered by insurance companies.
You can ask your state lawmaker to support autism insurance reform.
Chairman Kerry Rich
His email is
You can call him at (334)242-7538
Robert Kittle reports at WSPA:
 Parents of autistic children in South Carolina are asking state lawmakers to increase the state’s Medicaid budget that provides autism therapy. Parents, children, and advocates rallied Wednesday at the Statehouse and held signs as state senators came into the Statehouse Wednesday.
The problem is that South Carolina pays providers the lowest rate in the nation for that therapy. South Carolina reimburses providers $14.48 an hour for that therapy, compared to $50 in North Carolina. Because of that, South Carolina has a lot fewer professionals who provide that therapy, known as Applied Behavioral Analysis, or ABA. Since there aren’t as many providers, South Carolina has a waiting list of about 1,500 children who need the therapy and can’t get it.
Rep. James Smith, D-Columbia, says they’re asking for lawmakers to add at least $10 million to the state budget to increase the reimbursements, which would mean more providers offering that therapy. While it’s difficult to get lawmakers to go along with a budget increase when there are so many things competing for that money, Rep. Smith says it costs the state up to $2.4 million for lifelong care for each child who doesn’t receive the therapy. “The reality is the cost of not spending that money is costing our state far more,” he says.
The House adopted its version of the state budget early Wednesday morning and it did not contain the additional money, so advocates are hoping the Senate will add it.
Sen. Tom Corbin, R-Travelers Rest, says he’ll fight for every dollar he can. His 19-year-old twin sons were born prematurely and were diagnosed with autism. “My wife decided to leave her career teaching school and stay home with our children and see that they got the early intervention and therapies that they need. Does it work? I’m proud to say yes, it works. Both of my sons, through tremendous effort on their part and through early intervention and all the therapists and all the help we received, graduated high school summa cum laude,” he says.