New York Moves to Require Insurance Companies to Cover Autism

Filed under: In The News, Special Needs

New York legislators passed a bill this week to
require insurance companies to cover autism-related treatments, screenings and diagnoses.

"It would be unconscionable to force New Yorkers to pay out-of-pocket for this common, chronic condition," New York Assembly Speaker Sheldon Silver tells The New York Times.

If signed by Gov. David A. Paterson, the bill would make New York the 22nd state to require insurance companies to cover autism treatments. While the bill is hailed by autism advocates, there's some grumbling in insurance offices.

"The bill sponsors acknowledge it will raise premiums up to 2 percent," Paul F. Macielak, chief executive of the New York Health Plan Association, an insurance industry group, tells The Times. "Each additional coverage requirement, while they may seem well intentioned, also carries a cost."

Legislators recently have proposed insurance companies cover prenatal vitamins, infant baby formula and wheelchair purchases.
"Lawmakers can't have it both ways," Macielak tells The Times. "It's hypocritical for them to criticize insurance premiums as being too high and then turn around and mandate a slew of new benefits that only drive up costs."

Macielak's estimates for how much the autism bill will hike insurance premiums are overblown, Peter H. Bell, an executive vice president of the advocacy group Autism Speaks, tells The Times.

"Our estimate is that it was closer to a 0.5 percent premium increase, and our experience in other states is that the increase is lower than expected," he says.

Bell hails the new bill, telling The Times it is more ambitious than laws passed in most other states.

"It has the potential to be the most comprehensive of its kind, because other states have a dollar cap and an age cap, which means that the treatments are only available up to a certain amount of money or for specific ages," he tells the newspaper. "But the bill in New York does not have those limitations."

The Times reports the autism rate among children in New York has been increasing by about 15 percent annually. According to the American Academy of Pediatrics, which supports the bill, autism now affects close to one in 90 children.

That might explain the bipartisan support for the bill. Autism doesn't have a political party, but touches families directly on both sides of the aisle.

State Sen. Roy J. McDonald, a Saratoga County Republican with two autistic grandchildren, supports the bill but tells The Times it's not enough.

"This is the next step towards making certain that individuals with autism and their families are given the appropriate insurance coverage they deserve and have earned," he tells The Times. "But this is only the beginning, and the state needs to do more."

Related: 10 Common Autism Myths

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AdviceMama Says:
Start by teaching him that it is safe to do so.