I have been wondering how this was all going to shake out and I found this interesting article in the USAToday.
Autism advocates celebrated what they thought was a major victory
when President Obama signed the Affordable Care Act in 2010: They
expected the law to require all insurance companies to cover
instead of creating a national standard for autism coverage, the
administration bowed to political pressure from states and insurers and
left it to states to define, within certain parameters, the "essential
benefits" that insurance companies must provide.
requirements for autism treatments, such as behavioral counseling and
speech and occupational therapy, already vary from state to state. Far
from smoothing out those differences, critics say the ACA will add a new
layer of complexity.
The U.S. Department of Health and Human
Services (HHS) says it will consider setting a national standard in
2016. Until then, states will decide what autism treatments insurance
companies must cover.
Question: What is autism, how is it treated and at what cost?
is a mental disorder affecting more than 2 million Americans and tens
of millions of people worldwide. According to the U.S. Centers for
Disease Control, one in every 88 children in the U.S has the condition,
and the number is rising. Paying for treatment can be financially
catastrophic to families.
Symptoms of autism first appear
from birth to early childhood, and include mild to severe social,
communication and behavioral challenges as well as repetitive behaviors.
Treatments include counseling, speech and physical therapy and
Advocates say applied behavior analysis (ABA), in
which a therapist reinforces positive behaviors in the patient, is
essential to helping children with autism reach their full potential.
ABA, developed in the 1960s, has become the most widely used autism
treatment. But it requires hours of intensive, one-on-one therapy, and
costs as much as $60,000 a year.
Depending on the severity of
symptoms, a trained therapist using ABA may spend as many as 40 hours a
week with a child. A new study by researchers at the University of
Pennsylvania and the London School of Economics estimates the cost of
treating a person with autism during his or her lifetime is $2.3
million. Autism costs Americans an estimated $126 billion annually, a
number that has more than tripled since 2006.
Question: Who opposes board coverage of autism treatments?
ABA is endorsed by the American Medical Association, the American
Academy of Pediatrics, and the U.S. Surgeon General. But insurance
companies often object to paying for it because they say it is unproven
and is largely educational, not medical. Consumer advocates led by the
Council for Affordable Health Insurance also argue that covering ABA is
so costly it causes insurance premiums to rise, making basic health
coverage unaffordable for millions of Americans.
Read the whole article at USAToday.com