This year we have 4 bills under consideration to require health insurers to cover autism therapies and treatments: HB 2074, HB 2405, SB 2631 and SB 2603. The goal is to end health insurance discrimination against autistic children this year.
Autism is a complex neurobiological disorder that affects approximately 1 in 100 children, resulting in social and communication deficits, as well as repetitive behaviors. It is 4 to 5 times as likely to afflict boys. It affects more children than childhood cancers, diabetes, pediatric AIDS and Cystic Fibrosis, combined. Here's a link for more information about autism. In Hawaii, most health insurance covers very little for autistic children. These kids often need physical therapy, occupational therapy, speech therapy, and in particular, a therapy called Applied Behavior Analysis (ABA). ABA is done one-on-one, making it very expensive. This is particularly of interest to families, because it is a proven treatment for children suffering from autism. Even though the schools provide these therapies to autistic children, often it isn't enough. ABA typically runs between $50 and $100 an hour. If this was a benefit covered by insurance, providers would negotiate fair rates with insurance companies and families would pay a reasonable co-pay. Currently 29 states now require health insurance to cover autism therapies, but this has been done through legislation rather than insurance companies recognizing it as the right thing to do. With treatment, many of these children lose their autism diagnosis altogether, and the majority of the rest improve to such a degree they can lead more independent, higher quality lives. ABA therapy has been used for decades to treat autism, yet the insurance industry continues to deny coverage for ABA therapy, often on the basis that it is experimental. This conclusion is not supported by the science, and the Surgeon General, the National Research Council, and the American Academy of Pediatrics have all endorsed ABA. Studies show that if ABA therapy is administered intensively by properly trained therapists, half of the treated children will overcome their autistic characteristics to such an extent they can enter 1st grade indistinguishable from their peers. The other half make significant gains, too, resulting in them requiring less support for the rest of their lives.