Autism Insurance Coverage

Article first published as Autism Insurance Coverage on Technorati.

California recently passed, and Governor Brown recently signed, SB 946, a bill requiring health insurance companies to cover behavioral, vocational, and occupational therapies for those diagnosed with Autism. The Insurance companies were firmly against it, as they claimed it would increase insurance costs in California by more then $850 million a year (an independent commission estimated the increase at only $98 million a year). David Lazarus, from whose article I received these numbers, sees it as a good argument for a national healthcare system where risk is more evenly divided amongst all tax-payers, thereby lowering costs even more.

Government intervention in the healthcare system is a huge political hot topic right now, with the "Obamacare" issue for the Republicans, the single public "Medicare Plus" plan issue for Democrats, and in the middle are patients that are in need. Right now children on the Spectrum are struggling in schools to learn, not just their three R's, but how to be social. They learn things like why it's important to brush your teeth, look someone in the eye, reply when a question is asked, and how others are reacting based on body language queues with which children who are neurotypical have no problems. In some States, such as my home State of Utah, Autism is not covered at all as a diagnosis. So even getting your child screened for Autism is an expensive proposition if schools are not willing to provide that service themselves through a school psychologist.

There have been numerous genetic links to Autism, showing that Autism is more than just a result of poor parenting as was originally believed. The idea that Autism is anything but a physiological issue has been ruled out. The argument still rages on between genetics and environmental triggers, but cause doesn't invalidate treatment. Regardless of the cause, these children are in need of help. And as such, we as parents are doing everything we can with the meager resources provided.

As a parent of a child on the Spectrum, I spend as much time as I can trying to prepare him for the world. At a tender age of 6 I'm trying to teach him things he would normally have picked up naturally by 4. Things like brushing his teeth, using the toilet appropriately, keeping clean, and using utensils when eating. On top of that are his academic needs, which he tends to excel at when prompted, but still needs prompting in order to keep him on task. All the while I worry about his social skills, and work to help him focus on eye contact and social rituals like shaking hands and high-fives.

The problem is, I'm not there all day to instruct him because of work. My wife isn't either because she works as well. He is currently in school all day (which is very nice), but even then his classroom has other children that are in need. Some have even more need than does my son. That, and with meager resources as well, the school is doing the best they can with what they have.

I'm not complaining about the school, as our school district is better equipped than many others in the State to assist children on the Spectrum, but rather I am concerned about the lack of funds. Governments cannot afford to provide the funds for the needs of those children and adults with Autism, particularly in this economic climate. Parents generally are not in a financial position to fit all of the bill either, for the same reasons. It's become an impasse that few are willing to address, because no one wants to take the burden of cost, leaving individual families to bear the heavy weight for therapies.

We talk so much about research, causes, cures, etc., that we often forget the human aspect of Autism. Parents are struggling and siblings feel neglected because of the attention their sibling with Autism currently receives through family-based therapy. But eventually Governments will start to feel the pinch as parents pass away and siblings (if there are any) are unable to care for an adult on the Spectrum that didn't have the opportunity to receive the important therapy now available. It's no wonder both parents and government entities are looking to Insurance, now mandated because of the recent Patient Protection and Affordable Care Act, to provide funds for therapy for this biological condition.