Utah is one of the states that does not require private health insurance companies to cover the cost of autism treatment in a health plan. This could change if a bill designed to help families afford the treatment their child requires is passed into law. Advocates made their point about how badly this bill was needed by using brightly colored plastic balls to represent each child it would help.
In Utah, there is a bill called SB55. It was released by Senator Brian Shiozawa. The bill was endorsed by Autism Speaks, a national advocacy group. If passed into law, it would require private health insurance companies in Utah to cover autism therapy – something that 32 other states already require private insurers to do.
To make a point about how vital this is to the families of Utah, an advocacy group, the Utah Autism Coalition, set up a ball pit in the Capitol rotunda. It contained 18,532 plastic, brightly colored, balls. The number was not random. Each ball represented one of the children in Utah that have autism. This is an extremely clever, and eye-catching way to make their point. It let everyone who saw the ball pit know exactly how many 18,532 was.
Fortunately, SB55 emerged from the Utah Senate Business and Labor committee on a 5 to 2 vote. The bill would require autism coverage for children through age 17, with a benefit of $50,000 a year for kids through the age of 8, and $25,000 a year for older children. This is a victory for families in Utah who have children with autism.
The fight isn’t over yet, though. The health insurance industry is opposed to the idea of being required to provide coverage for autism. They would prefer that Utah wait to see what the outcome is of the pilot programs that state set up in lieu of a mandate last year. Those programs do not cover many children, and the funding that insurers said they would provide for it never appeared.
Another thing that must happen is the bill must pass by Utah’s House of Representatives. The bill is now called HB55. It appears that the bill that passed the Senate is going to require a compromise before the House will consider passing it.
One issue is that Utah doesn’t have a sufficient supply of therapists who are trained and certified to provide applied behavior analysis (ABA) therapy. The bill has been altered to include state-licensed mental health providers to administer the treatment. Senator Shiozawa feels that more therapists will train to provide ABA once private insurance is required to cover it. Right now, therapists who provide ABA therapy get little reimbursement.
Some lawmakers want the bill altered to reduce coverage for children who are older than 9. They also want language in the bill that would allow an end to coverage of treatment that “truly appears to not be working”.
Image by Maret Hosemann on Flickr