Seventeen states afford some level of coverage for autism-related services, according to a report from the Connecticut Office of Legislative Research. The report, dated December 27, 2006, came in response to inquiries from state lawmakers wondering "if health insurance policies cover physical, speech and occupational therapy for autistic children and if not, whether the legislature could require coverage."
With a rise in the prevalence of autism spectrum disorders among children in the country, a number of states have been considering proposals to require health insurers to cover autism-related services. Last month, Wisconsin Gov. James Doyle came out in support of such coverage (see more here) and the Pennsylvania legislature took up consideration of a bill that would provide coverage (read more here). New Mexico also has taken up the issue.
The Connecticut report notes that health insurance policies in the state must cover "certain mental illnesses" and that the law appears to cover the diagnosis and treatment of autism -- though it's unclear whether such treatment includes physical, speech and occupational therapy. State lawmakers "could refine the state insurance laws to specify certain coverage requirements for autism," the report says.
Interestingly, the report also notes that the state Insurance Department staff "declined to comment on the extent of coverage required for autism due to their lack of medical expertise." The agency did say that policies must cover "medically necessary early intervention services" from birth to age 3, with expense caps of $3,200 per child per year, or $9,600 per child per year until age 3.
You can find a copy of the report online here, via the Connecticut General Assembly website. The state Office of Legislative Research has an online section of the website here.
Aside from Connecticut, the report finds that six other states -- Georgia, Indiana, Kentucky, Maryland, New York and Tennessee -- have laws that specifically address insurance coverage for autism-related services.
Ten other states -- California, Illinois, Iowa, Kansas, Louisiana, Maine, Montana, New Hampshire, New Jersey and Virginia -- require coverage for autism-related services as part of laws that say insurers must cover autism as they do other mental illnesses.