Ohio House Takes Up Autism Health Insurance Bill

The Ohio House of Representatives is considering a bill that would prohibit health insurers from excluding insurance coverage for autism services.

The bill is called H.B. 170, which you can read via the state legislature's website by clicking here. Representatives Jon M. Peterson, a Republican, and Ted Celeste, a Democrat, are co-sponsors of the bill. The bill, introduced in April 2007, does not spell out what kinds of services are covered. According to the legislature's website (which warns that it not to be considered an official record), the bill has been resting with the House insurance committee.

The Associated Press published a story Nov. 8 that summarizes a pattern of activity which advocates for autism services will recognize: a growing awareness that autism services for young children can cost families tens of thousands of dollars a year; health insurance doesn't cover any of it; bipartisan support in the legislature generates a bill to change matters; and a health insurance industry representative oppose the idea. It's a pattern that has played out in several states, including Texas (passed), South Carolina (passed) and Pennsylvania, which as I understand it is still pending. (See past Autism Bulletin articles labeled "health insurance" and an autism insurance map for more background on states around the country.)

In Ohio, the Associated Press lays out two views of the debate by quoting an insurance industry representative, who suggests that autism is another in a list of causes some people would like to see insurers cover; and a provider of autism services, who relays the argument that investing in these services has a long-term return:

Insurance officials are concerned the bill would lead to more mandates based on a disease or health condition.

"Each individual has the belief that their cause is the one that the government needs to find the solution to," said Kelly McGivern, president of the Ohio Association of Health Plans. "We believe employers who buy policies should make the decision."

Continuing treatments, involving such things as speech therapy, a psychologist working on socialization skills and home health aides, aren't covered, said Jacquie Wynn, director of the Center for Autism Spectrum Disorders at Nationwide Children's Hospital.

Autistic children, she said, need 30 hours to 40 hours of intervention a week. Wynn said 30 percent of families who come to the center for treatment leave because they can't afford it.

"There's a cost savings in the reduction of aggressive behavior or the self-care skills they learn," she said. "With short-term, early intervention in their early years, you see the payoff in their lifetime."