According to the U.S. Centers for Disease Control
and Prevention, about one in every 150 children is affected by an
autism spectrum disorder (ASD). The American Psychiatric Association
classifies autism as a "pervasive developmental disorder" that
affects communication, social interaction, and patterns of behavior,
interests and activities.
The Autism Society of America estimates that the
lifetime cost of caring for a child with autism ranges from $3.5
million to $5 million. While there is no cure for autism, early
diagnosis and intensive therapy can significantly improve outcomes.
It is not surprising, then, that many of the laws that have been
passed or are being considered focus on increasing insurance
coverage.
Illinois, Kansas and Iowa require
insurers to cover autism-related services the same as mental
illnesses. HB 170 in Ohio would prohibit fully insured health
plans from excluding coverage for diagnosis and treatment of autism.
Indiana is the only Midwestern state mandating insurance
coverage for autism and similar disorders on par with that for
physical illnesses. During the current legislative session, bills
were introduced in Illinois (SB 1900), Kansas (SB 406), Michigan
(HB 5527 and HB 5529) and Wisconsin (SB 178) to require
insurance companies to cover autism treatment.
Wisconsin has a federal waiver to provide in-home
services to children diagnosed with ASD. This year, an insurance
mandate passed the Senate, but the Assembly substituted for that
bill different language (also contained in AB 901) that would
instead provide $6 million for services to children diagnosed with
ASD who are on a statewide waiting list (the current waiting period
is more than a year and a half). No agreement was reached between
the chambers before the end of regular session.
Some states are considering measures that would provide direct
autism-treatment funding. Illinois’ HB 2041 would allocate $52
million to families so they can access services and supports for
developmental disabilities, including autism. States are seeking
more information on the issue as well. Last year, Kansas enacted SB
138, creating an autism task force. Also, the Michigan House passed
bills in March that would create the Autism Research Fund (HB 5528)
and allow donations to it on tax returns (HB 5526).
