Joined by legislative sponsors and advocates on autism issues, Gov. Jay Nixon today detailed new legislation that will require coverage of autism diagnosis and treatment, including medically necessary Applied Behavioral Analysis (ABA), under health insurance policies written in Missouri.
“As autism becomes an even more commonly diagnosed condition for children in Missouri and across our country, it is vital that we take bold action to make sure that families have access to the diagnosis and treatment services they need,” Gov. Nixon said as he stood with representatives from the Republican and Democratic House and Senate. “I thank the bipartisan team of legislators for their work on this important issue and I urge the General Assembly to take up this legislation quickly and send it to my desk.
The legislation, which has been pre-filed in the Senate by State Senator Scott Rupp (R-Wentzville), with co-sponsor State Senator Eric Schmitt (R-Glendale), and in the House of Representatives by State Representative Dwight Scharnhorst (R-Manchester) focuses on four guiding principles that will assist families and children seeking treatment for autism. These include:
Health insurance carriers that issue or renew health benefit plans on or after January 1, 2011, must provide coverage for the diagnosis and treatment of Autism Spectrum Disorders;
This coverage must expressly include medically necessary, evidence-based Applied-Behavioral Analysis therapy, subject to a reasonable annual limit, under this legislation, $72,000;
Coverage must have no limit on the number of visits by an individual to an autism service provider for Applied Behavioral Analysis or for any other autism-related services; and
Carriers must not refuse to renew or refuse to reissue or otherwise terminate or restrict coverage on an individual or their dependent solely because the individual is diagnosed with an Autism Spectrum Disorder.
In support of these objectives, Sen. Scott Rupp stated, “If one out 100 kids in our local communities were being kidnapped, there would be a public outcry, and this neurological disorder is kidnapping Missouri’s children. I would like to thank my fellow legislators and the Governor for helping to bring this issue to light.”
Dr. Steve Kanne, Associate Director of the MU Thompson Center for Autism and Neurodevelopmental Disorders in Columbia, spoke to the importance of ABA therapies and the financial strain they place on families by sharing the story of a three-year-old girl who was brought to the Thompson Center by her single father.
After an in-depth analysis it was determined that the girl had autism. Upon hearing the diagnosis her father said, “This is my only daughter and I’ll do anything for her. Tell me what I need to do.” Kanne responded by sharing information about ABA therapy with the dad.
After a year of treatment the little girl was progressing well but “the father looked like he had aged ten years,” Kanne said. Struggling to pay for the very treatments that were helping his child to develop and grow he had taken on a second job and taken out a second mortgage on his house.
“I’m tired of hearing stories like these.” Kanne said, emphasizing that the autism insurance bill could help to alleviate them and give hope to families.
Miles Hinkel, the father of a son with autism, also spoke about the importance of early diagnosis and intervention. With tears in his eyes he recounted the hard decisions he and his wife have had to make regarding how they would pay for their son Blake’s treatment and therapies.
“Blake is a testament to the fact that ABA therapies can and do work.” he said.
With his own son on the autism spectrum, Senator Eric Schmitt also shared a personal perspective on the importance of the bill. “These therapies are the real key to bringing hope and opportunity to children affected by Autism and their families. That is why this is the year we hope to succeed by advancing autism insurance reform in Missouri.”
When asked about a possible increase in insurance premiums if the legislation passes, Gov. Nixon and John Huff, Director of the Department of Insurance responded that most employers providing health insurance will incur a less than one percent increase in premiums.
“Missouri is quickly becoming a leader in the diagnosis and treatment of autism,” said Gov. Nixon. “As a state, we must make sure that autistic children have access to life-changing therapies that will help them grow and achieve their full potential. This legislation, as introduced, does just that. I look forward to working with a broad, bipartisan coalition of legislators to move our state forward on this vital issue.”
The legislation, known as Senate Bill 618, is currently being reviewed. It is hoped that it will pass in both the Missouri House and Senate during the current legislative session.