On the heels of New York State legislature's passage of landmark legislation requiring insurance companies cover autism treatment, U.S. Senator Kirsten Gillibrand launched a new effort to make quality autism treatment affordable for families. According to data released by the American Academy of Pediatrics this past fall, 1 in 91 children suffer from Autism Spectrum Disorders (ASD). An estimated 48,000 children across New York suffer from Autism -- more than pediatric cancer, diabetes and AIDS combined. Of the 448,926 children in the Hudson Valley, an estimated 4,933 live with autism. Senator Gillibrand today discussed providing quality, affordable treatment to families who have children with ASD.
"The rate of autism is on the rise and the cost of treatment is increasing dramatically," said Senator Gillibrand. "We know that early intervention is one of the best ways to ensure a child's long term success, but thousands of families simply cannot afford the cost of treatment. New York has taken an important step, but we have more work to do to make quality treatment affordable."
"Autism is a public health crisis here in New York and across the country, and we are grateful to Senator Gillibrand for continuing to advocate for the resources needed to mount an effective fight against this disorder," said Peter Bell, executive vice president of programs and services at Autism Speaks. "Following the unanimous passage of a landmark bill to end insurers' discrimination against people with autism, New York is poised to set an important example. With Governor Paterson's signature, we will have removed a significant barrier to treatment for thousands of New Yorkers with autism and provided critical financial relief to their families. We strongly support Senator Gillibrand's efforts to stop this discrimination at the federal level."
An October 2009 study published in Pediatrics, based on the results of a survey of more than 78,000 parents, showed that 1 in 91 children are currently diagnosed with autism -- an estimated 637,000 children nationwide. Previous Centers for Disease Control and Prevention numbers had reported a rate of 1 in 150 children suffer from autism.
A new case of autism is diagnosed every 20 minutes -- making it the fastest-growing serious developmental condition in America. If the pace of this disorder continues, autism could reach 4 million Americans in the next 10 years. Despite autism's far reach, insurance companies still deny families coverage for necessary treatments -- costing them up to $6,000 out-of-pocket each month.
To help improve the lives of children and families living with ASD, Senator Gillibrand is fighting to ensure all families have access to affordable treatment:
Require Insurance Companies Across the Country to Cover Autism
New York State is leading the way, soon to be one of only 22 states to require insurance companies cover families living with ASD. Senator Gillibrand is urging Senate Leaders to pass the Autism Treatment Acceleration Act which would mandate that insurance companies cover ASD. The bill would require all private insurers nationwide to cover evidence-based, medically-necessary autism treatments and therapies -- including Applied Behavior Analysis (ABA) therapy.
ABA is a scientifically validated treatment program for ASD, recommended by the American Academy of Pediatrics and the National Academy of Sciences. ABA therapy is proven effective, but only at the recommended levels of 25-40 hours a week -- a level that can cost families up to $6,000 each week, which many families just can't afford in these tough economic times, or any time. The Autism Treatment Acceleration Act would make sure families can get the treatment their children need through coverage they can afford.
New Legislation to Cover Autism for Military Families
TRICARE -- the military health insurance program -- currently considers ABA therapy special education and not medically necessary treatment, and caps coverage for ABA at $3,000 a month. That amounts to only 16 hours of therapy a month -- a fraction of what's necessary to actually improve the life of a child suffering from autism. As a result, military families are forced to choose between paying out-of-pocket to get the therapy their children need, or forgoing therapy altogether. What's worse, thousands of military families are forced to the bottom of long waiting lists for a specialist each time they are relocated.
To combat these problems and help take the strain of military families living with autism, Senator Gillibrand wrote the USA Heroes Act to require TRICARE to cover autism treatment, including ABA therapy to help military families get the care their children need.
Reauthorize the Combating Autism Act
Next year, nearly $1 billion of funding dedicated to combating autism is at risk of getting cut. Senator Gillibrand is working with Senator Chris Dodd on legislation to reauthorize the bill. The legislation would provide funding for autism research, services, treatment, training programs and information dissemination programs.