Health insurance for people with autism

Most states do not require private insurance companies to cover even essential autism treatments and services. Nationwide, few private insurance companies or other employee benefit plans cover Applied Behavior Analysis (ABA) and other behavioral therapies. In fact, many insurance companies designate autism as a diagnostic exclusion, meaning that no autism-specific services are covered.

There are 16 states that require health insurance companies to cover therapies for autism. Our state of Wisconsin could join that list. A bill passed by the state senate awaits a decision in the Assembly and needs to be voted on by this Thursday, March 13 — when legislative sessions end.

After the Senate Bill (SB 178) passed with a vote of 25 to eight, Wisconsin realized that this is not an issue of democrats versus republicans — it’s a bipartisan issue with support from both sides of the aisle.

Gov. Jim Doyle, along with Senate and Assembly democrats and republicans, made a plea to the Assembly to at least hear this bill in session. Doyle remarked that Wisconsin families are not trying to get something for nothing with this legislation — hard working families who do their part and insure their families are just looking for the same coverage insurance companies give to so many other people with disabilities.

On February 28, supporters gathered at the state capital to rally the Assembly to take action. It was heart-breaking to hear the story of one family told by the grandparents of a young boy with autism. Their son, they said, works long hours to make sure he can provide for his family, including health insurance. But at the end of the day, there isn’t any more money to pay for autism therapy. And since their grandson is at the bottom of a two year waiting list for the Medicaid Waiver; other family members have been contributing money to help pay for some therapy.            

Families who have children with autism know that delivering treatment as early as possible gives children the best chance at life. But with the steep out-of-pocket costs and long waiting lists for state programs, Wisconsin families are looking for answers. 

Hopefully, the Assembly can provide them. Let Wisconsin legislators know how you feel about this issue — you can find their email addresses at the Wisconsin State Legislature
Web site.


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