Vote Yes For Insurance Reform For Autism sign now

It's a devastating diagnosis for a parent to hear, but it's a one-two punch when your insurance company then refuses to cover the critical, medically necessary therapies your child desperately needs. When our 3-year-old son was diagnosed with a developmental disability (Autism Spectrum Disorder / ASD) this past January, a team of medical experts prescribed a rigorous program of therapies. However, state-funded early intervention services are only able to offer us an hour and a half a week of speech therapy for a child who isn't talking. We found private therapists to work with our child, but when we asked about an insurance claim, the insurance company said, "We don't cover educational treatments. We appealed. They turned us down again. "We don't cover developmental problems," the claims manager said.

Thousands of families like ours who are dealing with autism are fortunate to have any health insurance at all. But in Virginia , insurance coverage does not pay for essential medical services that are the only proven method for helping kids with autism reach their full potential. The costs of intensive, one-on-one therapies, including speech, occupational and Applied Behavior Analysis (ABA), the gold standard in autism treatment, are prohibitive.

The yearly out-of-pocket expenses are equivalent to a year of private college tuition. So instead of getting a child the prescribed treatment regimen, which may entail 40 or more hours with therapists every week, families like ours cobble together whatever we can afford or we just do not get the required therapies for our children. We run through savings, college funds, and retirement money. It is a shared sacrifice that reverberates throughout the entire family.

According to the National Centers for Disease Control and Prevention, autism is now diagnosed in one in every 110 children, including one in 70 boys and rising. The number of children diagnosed with autism is skyrocketing, while school budgets are simultaneously constricting. Unfortunately, many school systems are ill-equipped and insufficiently funded to handle the job of providing all these services. Child development experts agree that giving a child intensive help during his toddler and pre-school years increases the likelihood that he will be mainstreamed and require fewer special services by the time he reaches kindergarten. Early intervention is our best hope of ensuring that those children become as independent and fully functioning as they are able.

It's cost- effective too: Providing children with intensive therapies early on will reduce the state-funded services they will need in their school years and throughout their lifetime. In February Senate passed Bill 464 by a vote of 27-13; legislation that will put Virginia at the forefront of a nationwide effort to provide health insurance coverage for people with autism. The bill died in subcommittee. Virginia stands poised to become the 24th state to require coverage of medically necessary ABA therapy, the most recognized, evidence-based treatment for autism. The Virginia law would cover treatments for people with autism throughout their life-span. Opponents have claimed that covering behavioral therapies for children with autism would dramatically increase insurance premiums. However, according to actuarial analyses conducted on the proposed Virginia legislation, the Virginia proposal would only result in modest premium increases of slightly over one-half of 1 percent upon full implementation.

The General Assembly will not convene to consider new legislation until January, 2011. It is a common-sense and fiscally responsible way to help families access the medically necessary, evidence-based autism therapies that they are currently excluded from receiving due to an autism diagnosis. Giving children access to treatments today gives them their best chance to become happy, healthy, and productive adults tomorrow. Please reconsider and pass Bill 464 for all of our childrens future.


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