While the media and politicians might want you to think otherwise, it’s not that difficult to understand the Affordable Care Act (commonly known as “Obamacare”) and, more specifically, whether you can now access insurance to cover autism treatment in your state. While the federal exchange website has experienced some problems, many of the state exchanges, such as those in California, Kentucky, and New York, are running smoothly. If you currently don’t have insurance that pays for autism treatment, you may live in one of the 27 states that is now offering that coverage through its state exchange, and you may qualify for federal subsidies to reduce the costs of that insurance.
Despite the collective efforts of the autism community, Governor Brown’s trailer bill has passed, which means that a new law will take effect on July 1, 2013, limiting regional center funding of co-pays and co-insurance and eliminating regional center funding of deductibles.
California’s autism community suffered major setbacks last week in its efforts to gain access to autism treatment for all Californians. In a last-minute change, Governor Brown and the Legislature struck a budget deal for Medi-Cal funding which fell short of a previous attempt by Assemblymember John Perez (D-Los Angeles) and Senator Ed Hernandez (D-West Covina) that would have given Medi-Cal beneficiaries the same benefits as the essential health benefits in California’s health exchange. As a result, Medi-Cal enrollees will not have coverage for autism treatment services, better known as applied behavior analysis (ABA). While some Medi-Cal enrollees will have access to ABA through California’s regional centers, many children with autism spectrum disorder (ASD) do not meet the regional centers’ more stringent criteria.
Earlier this month, the new Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was released. This has been highly anticipated by the autism community because the diagnostic criteria for autism spectrum disorder has been changed. Many autism community members – especially those whose children are diagnosed with Asperger syndrome – have expressed concerns about whether their children could lose their diagnosis and, consequently, lose access to treatment.
Senator Darrell Steinberg has authored a bill, SB 126, to extend California’s autism insurance mandate until July 1, 2019. Without this bill, the autism mandate will sunset in 2014. The Senate Health Committee will hear this bill on April 10th, and your letters in support of the bill are vital to its passage. For your convenience, we have attached a sample letter of support. Of course, we encourage you to share your personal story with Senator Steinberg regarding the importance of the autism insurance mandate to you and your family. All letters should be emailed to Louis.Vismara@sen.ca.gov or faxed to (916)327-8867. Your support makes all the difference!
As you may have heard, California’s Department of Insurance filed emergency regulations last month which were made permanent this week. These regulations reiterate existing law and target the delays and denials of insurance carriers who have sought to limit the application of California’s autism mandate. This is a great victory for California’s autism community, as the permanent regulations represent another tool in the arsenal of families who have been struggling to get authorization for autism treatment or battling with insurance carriers to get sufficient hours and authorizations in a timely fashion.
The Center for Autism and Related Disorders (CARD) is the only private, for-profit corporation contributing significantly to autism research in the United States, ranking third among non-governmental organizations contributing to autism research in the United States, according to the 2010 IACC Autism Spectrum Disorder Research Portfolio Analysis Report. The Interagency Autism Coordinating Committee, a federal advisory committee that coordinates all efforts within the Department of Health and Human Services concerning autism spectrum disorder (ASD), released its annual IACC Autism Spectrum Disorder Research Portfolio Analysis Report, which “tracks US inputs or investments into autism research.” CARD’s investment in autism research has increased every year since IACC began tracking autism research funding.