Published: Wednesday, April 1, 2015 at 7:01 p.m. Last Modified: Wednesday, April 1, 2015 at 7:01 p.m.
Parents of children diagnosed with autism could soon get help paying for treatment, thanks to a bill filed last week by Sen. Tom Apodaca that closely mirrors one passed by the N.C. House last year.
Senate Bill 676 requires group health insurers to cover adaptive behavior treatments for children with autism spectrum disorder, a group of developmental disabilities that can cause significant social, communication and behavioral challenges.
Beginning Oct. 1, the bill would mandate that insurers cover screenings, diagnosis and treatment of autism spectrum disorder for those 18 years or younger, with benefits capped at $40,000 per year. Coverage may not limit the number of clinical visits.
I think this is a good start to help some folks, Apodaca said Wednesday. This is a serious problem that's becoming bigger each year, so I'm excited about the progress we've made.
Currently, North Carolina is one of only 16 states in the country that doesn't require employer-based health plans to cover behavioral therapies for autism. The U.S. Centers for Disease Control says one in 70 children in North Carolina deal with a form of autism, higher than the national average.
Parents who seek behavioral treatment for their children with autism can spend upward of $30,000 a year, said Caroline Long, executive director of St. Gerard House. The Hendersonville nonprofit offers a therapy called Applied Behavior Analysis, which would be covered under the bill if prescribed by a licensed physician or psychologist.
As the mom of two children with autism, I used to have the chronic fear that if my kids lost their health insurance that I'd get thrown into the high-risk pool because of their diagnosis, Long said. So I'm glad that won't become a reality for other people if this bill becomes law.
In 2013, state Rep. Chuck McGrady, R-Henderson, with support from Rep. Chris Whitmire of Rosman, introduced a bill that would've required health plans to cover treatment of autism spectrum disorders up until 23 years of age and provide $36,000 a year in coverage for behavioral treatments.
It passed the N.C. House by a vote of 105-7, but died when it got to the Senate under pressure from insurance companies and business groups who didn't want coverage mandated by the government. Apodaca told the warring parties they needed to come up with a solution that helped families dealing with autism, or he would.
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Legislature appears headed toward autism coverage