In just two days Connecticut will become the 13th state to require all group health insurance policies to cover autism spectrum disorder diagnosis and expanded autism treatment for children ages 14 and younger.
Lawmakers and advocates celebrated the upcoming enactment of the new law at a Capitol press conference Wednesday.
The new law, which goes into effect on Jan. 1, requires insurance companies to cover not only diagnosis, but behavioral, physical, occupational, and speech therapies.
That’s good news for parent advocates like Shannon Knall of Simsbury who said the average out-of-pocket cost per year for parents of children with autism is $50,000 to $200,000. She said she can’t say with any certainty how much the legislation will help her finances just yet, but it’s a “huge step.”
“When Connecticut made Senate Bill 301 law we became a leader in the battle to end discrimination against families living with autism,” Knall said. “Not only is this the right thing to do for our families, but it’s the right thing to do for our state.”
Sen. Martin Looney, D-New Haven, said as the bill was debated the past few years lawmakers often heard stories from parents who had to move to a state that mandated coverage or take a second mortgage out on their homes.
Looney called passage of the bill one of the “highlights” of the 2009 legislative session.
In June the bill received almost unanimous support from both the House and the Senate with only two lawmakers voting against it.
“Autism is a perplexing and confusing and complicated disease,” state Rep. Steve Fontana, D-North Haven, said. “It defies a simple one-size-fits all treatment and I think this legislation recognizes and reflects that.”
However, one father whose child is on the state’s Husky insurance plan reminded the lawmakers Wednesday that the coverage included in the bill won’t be afforded to the more than 350,000 children on the state’s Medicaid program. He wondered when a facility like one in Massachusetts that treats autism spectrum disorders with doctors from a number of different disciplines practicing in one facility will be brought to Connecticut.
Massachusetts is not one of 13 states that offers insurance coverage of autism, Fontana said. He said Massachusetts may have a facility, but they don’t have the coverage. The father said coordinating 10 to 12 doctors to work with his child is difficult.
Sen. Joseph Crisco, D-Woodbridge, said the Sustinet plan passed by the legislature will help establish medical homes that will make the coordination of care much easier for those with frequent doctor visits.
“Now that insurance reform has come to the insurance capital of the world there really is no reason it can’t come to every other state in this country,” Knall said.
The autism bill “speaks to the issue,” House Speaker Chris Donovan, D-Meriden, said. “Which is the issue of the year. We’re talking about adequate health care coverage.“
“That’s what this bill says that people who have various illnesses should get covered for those illnesses,” Donovan said.
When asked what advice she may be able to give to other groups seeking coverage of their medical diseases or illnesses, Knall said it’s the old adage that the “squeaky wheel gets the grease.”
“You have to keep talking and talking and talking to your legislators until they really understand what life is like with that particular disability,” Knall said.
Earlier this year Republican Gov. M. Jodi Rell vetoed a bill that would have expanded insurance coverage for ostomy supplies, prosthetic devices, hearing aides for children, and wigs related to alopecia areata and bone marrow testing. In addition it would have required group insurance carriers to develop wellness plans.
“The simple truth is we cannot afford this bill,” Rell said when vetoing that piece of legislation.
The Office of Fiscal Analysis noted that the expanded coverage of autism spectrum disorders for children under the age of 14 will cost the state between $1.2 and $1.6 million per year. It may also increase health insurance premiums and costs for municipalities that are fully insured, the fiscal note states.
On July 15 when she signed the bill Rell said the autism bill “offers support—and more importantly, hope—to families of children coping with a deeply frustrating condition.”
Rell said she vetoed the other bill because it created new mandates for health insurers in the state.
Group health insurance companies didn’t fight the state’s decision to cover autism spectrum disorders, according to Fontana who co-chairs the legislature’s Insurance Committee.