Insurance vs. Autism: For Parents, Insurance Is a Personal Fight

Looking someone in the eye, waving goodbye, or speaking a single word may seem simple to the average person. But an autistic child may have to sit in a chair for eight hours a day, learning these tasks through painstaking repetition called Applied Behavioral Analysis therapy.

ABA therapy can cost up to a $100,000 a year, which is why it's a breakthrough that Arizona Gov. Janet Napolitano has signed House bill 2847 into law, forcing insurance providers to cover the costs of the treatment.

Click HERE to check if your state has passed laws requiring insurance providers to cover behavioral therapy for autistic children.

Mandated insurance coverage for autism treatment is, generally, nothing new. Roughly half the states do that to varying degrees. What's new is requiring coverage for ABA therapy, with its intimidating price tag.

The expense is so steep that the bill was lobbied against by business, in general, and the insurance industry, in particular, which argued that such mandated coverage gets passed along as higher insurance premiums for everyone.

"The weight of all of these mandates has made it much more difficult for employers and consumers to afford coverage for health care," Susan Pisano, spokeswoman for the American Association of Health Plans, said.

"The way it plays out in the real world is that, if a mandate passes, an employer has to pick that cost up — in the form of higher premiums — and many times, what then happens is, that cost will need to be passed on to the individual employee."

But Lisa Parles, whose 17-year-old son Andrew has been in ABA therapy — without insurance — since the age of 3, argues the skills he's learning will save society some of the cost of care he'll need as an adult. Parles gave up her law practice to move to a state that pays for treatment.

"If it wasn't for his early years of ABA, I don't think he'd be brushing his teeth, showering, getting his own snack," she said, "which for the future, as an adult, is going to have a huge financial impact."

Parles points to the overall economics.

"There's no question that, the more intensive early intervention services, the better the outcome — and that either we can pay for it now and hope for [the] best outcome, or you can pay for it later in the way of adult services," she said.

Though there are many childhood disabilities that insurance still will not pay to treat, parents of kids with autism — at least, now, in Arizona — may not need to take a second mortgage to pay for that time in a chair.

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