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@NCCapitol

Autism insurance coverage nears passage

Posted June 30, 2015

New research asks: When does autism begin?

— A bill that would require insurers to cover treatment for children with autism is a House vote away from passage.

Autism insurance coverage has overwhelmingly passed the House in recent years, only to languish in the Senate. That changed this year, however, when Sen. Tom Apodaca, R-Henderson, introduced a measure in March and shepherded it through the chamber by the end of April.

Apodaca's bill went before the House Insurance Committee on Tuesday, where it easily passed on a voice vote.

"We're long past arguing whether there should be insurance coverage for autism," Rep. Chuck McGrady, R-Henderson, told the committee.

Coverage would be capped at $40,000 per year and would be covered for children only through their 18th birthday, but advocates backed both conditions.

Lorri Unumb, vice president of state government affairs for Autism Speaks, said the average cost for a year of applied behavioral analysis is $14,000, and only children with severe autism would top the $40,000 cap for treatment. Unumb added that 42 states mandate insurance coverage for autism, and most have age restrictions.

"We'd like for it to apply to more people, but we realize the incremental nature of legislation," she said.

Sally Cameron, executive director of the North Carolina Psychological Association, said any recognized treatment would be covered, as long as it's been shown effective in published studies and is ordered by a licensed physician or psychologist.

Under the proposal, services would have to be provided by a licensed provider, such as a psychologist, speech pathologist, occupational therapist or social worker. Behavioral analysts aren't currently licensed professionals in North Carolina, but a separate bill that recently cleared the House would creating a licensing system for them, which would allow them to be paid by insurers for autism-related services they provide.

2 Comments

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  • Pam Snyder Jul 7, 2015
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    I agree not a choice!! It's a disease to be treated like any other!!

  • Nicolle Leney Jul 1, 2015
    user avatar

    This should be an easy decision. Autism is a disease like any other, it just has treatment that is different. Drugs can only be used to manage symptoms (agitation, etc). Treatment will only be covered if it's ordered by a physician or psychologist, so there's no reason this shouldn't be covered.