Autism panels show need for better insurance options

Autism is not a disease that families should have to face alone. Legislation has been introduced in both the state Senate and the state House of Representatives to make treatment programs more accessible to families through insurance coverage. To explain these efforts, and to give these families and researchers a chance to speak, my Senate colleagues and I are holding autism workgroup sessions in cities across the state.

We have held meetings at Eastern Michigan University and at the Detroit Medical Center. What we heard from professionals, parents and those who work directly with autistic children is that available treatments need to be more accessible to families. The most commonly prescribed treatment is applied behavior analysis, or ABA. Many insurance companies refuse to cover this because they consider it an experimental treatment. But ABA therapy has been endorsed, prescribed and used by many professionals who treat children with autism.

Insurance companies are on shaky ground when they call this treatment “experimental.” ABA is an expensive treatment that can cost families as much as $75,000 a year. Few families can afford this or other treatments. Michigan could become the 22nd state to require insurance coverage for autism treatments to help these and the thousands of other autism-impaired children and their families throughout Michigan.

With therapy some of these children may be able to care for themselves, live on their own, and even hold down a job. For those who look at the numbers, a 2006 Harvard study showed that a child not properly treated could cost society as much as $3 million which includes economic costs like lost productivity. The Michigan-based group Autism Speaks says that 15,000 Michigan children have an autism diagnosis. Those numbers added to Harvard’s estimated cost of $3 million clearly show that it would be more cost effective for insurance to cover autism treatments.

Data from some states with autism insurance coverage shows that offering coverage does not mean that insurance policies will be unaffordable. In Minnesota, where there is no limit on age or treatment costs, Autism Speaks reports that insurance premiums have only increased by 83 cents. Lorri Unumb, from Autism Speaks, worked on the South Carolina law that requires insurance coverage for autism treatments. Unumb testified at our May workgroup that the South Carolina Fiscal Agency estimate that offering autism insurance coverage to state workers would cost $18.9 million was wrong. The actual cost to offer this coverage to 350,000 state workers was only $856,000. South Carolina’s law now covers treatments including ABA therapy. Coverage for behavioral therapies is subject to a $50,000 maximum per year.

Autism Speaks says that 1 in 110 Michigan children are diagnosed with autism. So while my colleagues and I are fighting in Lansing to pass legislation to help families by making treatment more accessible, other institutions are doing research to find out what treatments work best. Children are different, so one specific treatment or intervention will not help every child. They are researching new treatments to find out what works best. They are training more new teachers and professionals to work with families and children. They are training current workers doing intervention services in our communities who need to keep updating their skills and knowledge. They are working on services for teenagers and adults, because autism changes over time and we cannot just drop treatment as these children grow.

These workgroups will help us keep the pressure on to move the bills now in the Senate Committee on Economic Development and Regulatory Reform. None of the families that we heard from are asking for a handout. They are willing to buy insurance policies to help with the cost of treatment. They simply want the opportunity for their children to reach their full potential and contribute to society in any way that they can. It is time for Michigan to answer these families and be the 22nd state to offer insurance coverage for autism treatments.

(Sen. Tupac Hunter represents the 5th District, which comprises Dearborn Heights, Inkster and northwest Detroit. He serves as minority vice chairman of the Banking & Financial Institutions and the Homeland Security & Emerging Technologies committees. He is also a member of the Commerce & Tourism and the Economic Development & Regulatory Reform committees.)