Insurance Coverage for Behavior Therapy

by Marlene Gundlach on October 21, 2008

As the election comes to a head, members of Autism Speaks are fighting their own political battle. There is a great disparity between states when it comes to insurance coverage for behavior therapy for autism. In Washington, one family pays $1,000 a week for behavior therapy for their son, while in Indiana, another family pays $3,000 a year after their insurance pays its share.

The Battleground

Autism advocates want to see more states follow the example set forth in Indiana, which requires insurance companies to cover costly behavior therapy for autism. Since 2002, six states — Texas, Pennsylvania, South Carolina, Arizona, Florida, Louisiana — passed laws requiring this type of coverage. In some cases, it saves families up to $50,000 a year. Parents have shared stories of how the behavior therapy has helped their autistic children. Arzu Forough’s son, from Washington, was taught, at the age of 3, to make a sound when he wanted a drink of water.. Now, at 12, he is learning to share his feelings instead of throwing tantrums. Applied Behavior Analysis (ABA) often uses a reward system to help autistic children learn new communication and behavioral skills, and parents see positive results.

In 2008, Autism Speaks endorsed bills in New Jersey, Virginia, and Michigan to ensure this coverage is available. In 2009, it hopes to back similar bills in Ohio, New  York, and California. Lawmakers find themselves in a difficult position since voting against these bills is a vote against families. In the financial bailout plan passed in October 2008, a measure was tacked on to the bill requiring insurers to make coverage for mental health patients equitable with other health coverage. Advocates with Autism Speaks applaud the additive measure, but state that it does not benefit autism patients since autism is not a psychological condition and it is not covered under mental health services.

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