By Felice Brenner, Chair, Board of Directors, ABC of NC Child Development Center

ABC of NC Child Development Center is asking North Carolina lawmakers to right an unfortunate injustice this legislative session.

Nearly 60,000 individuals with autism and their families face unfair financial hardship because their private health insurance specifically excludes many autism services.  To correct this, the local school for children with autism invites Triad residents to encourage their State Senators to support House Bill 498 which requires private health insurance companies and the State Health Plan to cover the diagnosis and treatment of autism.

Supporters can find and write their senator about their support here.

Thirty-three states require autism insurance coverage; eight more are considering it. This legislation has afforded thousands of families in other states access to autism treatment that until now was available only in select corporations and through the federal government’s TRICARE insurance program. {Picture caption: States in white have no autism insurance legislation.}

According to the Center for Disease Control (CDC), one in 70 North Carolinians are born with autism, an incurable but treatable neurobiological disorder that affects communication, social interaction and behavior. The CDC describes autism as one of the nation’s most critical health issues, and its incidence is on the rise. Autism affects more children than cancer, AIDS and diabetes combined.

And it does not differ from other incurable chronic medical conditions that health insurance routinely covers, including asthma, diabetes and hypertension.

Bev Moore, a Winston-Salem mother of a child with autism, says that the current exclusion of autism services in health insurance policies leads to tragic circumstances for hundreds of Triad families who have children with autism.

“Learning that your child has been diagnosed with a serious medical condition like autism is devastating. Learning that there is treatment available that is proven to work but your child cannot get that treatment unless you have private resources is heartbreaking,” said Moore.

Fortunately, Moore’s son, Kirby, is able to obtain autism services at ABC of NC and is now living well with his developmental disability.

Moore said, “Our family was fortunate and had family savings to pay privately the enormous cost of the treatment. Not every family can do that. Imagine being a young couple just starting out, and you learn that your young child has autism. What do you do? Move to another state that offers such coverage? Not provide effective treatment for your loved one with autism? Neither decision is good for the state of North Carolina or its citizens. My child–our children–deserve health insurance coverage for the diagnosis and treatment of autism just like any other medical condition that is treatable.”

The cost of autism care is $90 billion a year in the U.S. – a heavy burden on the families who live with the disorder but cannot afford appropriate treatment. These families are paying health insurance premiums, yet their child with autism is excluded from coverage.

Unreimbursed out-of-pocket expenditures for medical care and autism treatment put families in financial insecurity, debt and even bankruptcy as they use savings and retirement funds to pay for needed therapies. Alternatively, families are forced to make the agonizing decision not to provide their child with evidenced-based therapies known to improve symptoms dramatically.

While the costs of autism care are staggering, the cost for autism health insurance coverage is minimal. The insurance industry’s own claims data show that autism insurance coverage generates an increase in premiums of less than one percent.

In our state, that small investment would yield big returns. Autism treatment focuses on diminishing or controlling symptoms that can range from mild to quite severe. Research shows that symptoms of autism can be improved by appropriate therapies that improve the quality of life for the individual and his or her family, which reduces the long-term costs to society of caring for untreated children. Every new child diagnosed with autism will cost an estimated $3.2 million over a lifetime. Early diagnosis and intervention can reduce this cost by two-thirds. Autism insurance coverage will help make this happen.

Autism insurance coverage would reduce costs to schools because children with autism would receive a head start on appropriate therapies before they entered the school system. Autism insurance coverage would also attract new health care jobs to North Carolina. Availability and access to board-certified behavior analysts and other autism treatment providers would grow if lawmakers require autism insurance coverage.

Concerned parents may write their NC General Assembly Senator with the following talking/message points:
~ You have a child on the autism spectrum, care about someone with autism, or are on the spectrum yourself and support HB 498, Autism Health Insurance Coverage.
~ Share a short version of your story about how autism has touched your life.

To learn more about House Bill 498 and to stay up-to-date on autism insurance legislation, please visit one of the following websites listed below, or like ABC of NC Child Development Center on Facebook.

Sponsored by ABC of NC