Monday, May 28, 2007

Mapping the 23 States Which Have or Are Considering Autism Insurance Rules

Children with autism spectrum disorders often require a lot of one-on-one services (30 hours per week for example, in the case of a preschool student) to enable them to learn and develop new skills. So with a rising number of autism diagnoses around the nation, and a growing demand for these services, it's not surprising to find that a number of states have considered putting laws on the books that relate to autism and health insurance coverage.

The annotated map below shows the 23 states mentioned in recent months in Autism Bulletin articles as either having laws on the books for health insurance or having governors and state lawmakers discussing proposals to provide more coverage for autism-related services. Click on one of the red pins posted at a state capital to see a brief summary of what that state requires. For readers who are new to these online Google maps, you can use your mouse to click on the map and move your view to a certain part of the country; you can also use the scale in the upper left corner of the map and click on "+" to make a view of the map bigger, or "-" to make it smaller. (If you are an e-mail subscriber and don't see the map, please click here.)

A key question is, what do these laws or proposed laws cover?

The answer is, it depends on where you live, and in many cases, what the standards or mental illness health insurance coverage are for the health insurers in your state. The reason for that second point is that many of the laws written so far emphasize that health insurers must not discriminate against autism patients and must treat them as they would patients with a mental illness. (This applies to more than 11 states on the map.)

But what does that mean? Does that cover the one-on-one sessions for applied behavior analysis (ABA) that many young children find beneficial, for example? Does it cover speech therapy from which many kids trying to learn how to talk can benefit? If it does cover these sessions, are they limited to X number of sessions per year? (And if that's true, is mental illness the right metaphor for health care coverage for autism? It's not like it goes away after a certain number of therapy sessions.)

Costs are also a factor; states such as Connecticut and Kentucky put caps on spending per child per year. Many states also restrict ages up to which insurers need to reimburse families.

Indiana and South Carolina (where the legislature passed a bill last week) appear to have the most comprehensive plans; one reason: both explicitly tie autism services to medical diagnosis and prohibit capping costs for coverage.

Please let me know if you find this map useful. If you have information to add from your state, please leave a comment on this blog post, or write to me at michaelsgoldberg AT

1 comment:

Anonymous said...

Cool map. Thanks for the national perspective. Does Massachusetts have anything in the works?