Insurance companies will have to help pay for autism treatments in Alaska under legislation that’s now slated to become law. Governor Sean Parnell gave tacit approval to the measure this month by sending it back to the legislature without his signature. The new requirement only covers a portion of the insurance market for now. However, supporters see it as an important step in providing some relief for parents who struggle with the high cost of autism therapy and counseling.
Click here to download or listen to a a mobile-friendly version or the above audio
Petersburg parent Kari Petersen has insurance, but she says it doesn’t cover her son’s autism. Petersen says the disorder is defined by an individual’s ability to relate and communicate with others. Her family pays out of pocket for counseling to help her son build those skills, but they can’t afford some of the specialized therapy and evaluation services he needs.
“One thing I’ve always wanted to get for him that has been out of reach from the beginning is speech therapy services. They’re just so expensive but it’s something he’s needed from the very beginning but hasn’t been able to get,” says Petersen.
Senate Bill 74 requires that insurers cover behavior and speech therapy as well as other treatments for children with Autism Spectrum disorder. It does not apply to all insurance plans, but Petersen is cautiously optimistic about the new law.
She says, “We pay health insurance, but we also have to pay 100 percent of the cost of our child’s autistic treatments because health insurance refuses to cover them. That and the fact that the governor didn’t sign it does not lead me to be overjoyed about the bill but I do think it’s a step in the right direction”
The bill passed the legislature this spring with bi-partisan support. Governor Sean Parnell chose to send it back to the legislature without signing it which means it will become law late this month. In a June 12th letter to the Senate, Parnell expressed support for the measure while acknowledging concerns opponents had raised about increased premium costs for business. The Governor ultimately concluded that, “The long-term cost savings of discovering and intervening in ASD (Autism Spectrum Disorder) early in a person’s life justify letting this legislation become law.”
Anchorage Democrats Johnny Ellis in the Senate and Pete Petersen in the house sponsored the legislation. Ellis calls it a godsend for the parents of autistic children in Alaska:
“There are proven medical treatments for children that get people to a higher level of functioning who experience autism and that’s a great cost savings and great for Alaska families so it’s a great step forward for these families,” Ellis says.
The bill includes an exemption for small businesses, which was a compromise sponsors made to get the measure passed. Also, according to Ellis, the legislature cannot mandate the coverage for state workers or self-insured corporations. However, Ellis predicts the state will adopt the coverage in its next employee bargaining cycle as it has with past mandates like breast cancer and prostate screening.
“We’re setting the ball in motion. We’re setting an example. We are legislating the portion of the market that we can legislate and if the past is any guide, and I believe it is, state employees will follow. And that will cover a lot of families. And then major insurers that are self-insured will follow suit as well to attract and retain the best employees to be competitive in the hiring market for good employees. Its an incremental process, but you have to do the right thing and get the ball rolling and that’s what we’ve done here today,” says Ellis.
Opponents of the bill included the health insurance company Premera Blue Cross Blue Shield of Alaska. In comments to the legislature this spring, Senior Vice President Jack McRae argued that some of the services covered in the law are the responsibility of school districts rather than insurers. McRae wrote, “The proposal would add to the overall cost of healthcare and would be borne by insured members.” According to media relations manager Amy Carter, Premera still has those concerns. However, in an email response to an interview request, Carter said the company was, “working to implement this as smoothly as possible for our customers.”
Parent Kari Petersen considers the lack of autism coverage an injustice and she says she’s grateful the law at least addresses the issue. Petersen emphasizes that autism is treatable and she says that treatment is so important because it not only affects the individual, but everyone in their lives.
“The families have been bearing the financial burden of treating this but it’s not just the families. If you have kids that aren’t being treated and they go to school and then the school, they’re not being given the funds to treat autism. They’re given the funds to educate the child and then they also are tasked with that without any funds for it. Also, these kids and individuals end up in state services and we as the public end up paying for something that insurance companies really need to be paying for,” says Petersen.
Senate bill 74 includes the creation of a legislative task force which will draft a statewide plan for the early diagnosis and treatment of autism. The insurance requirement goes into effect for policies issued or renewed after January 1st 2013.