California Law Requires Insurers to Cover Autism Therapy, But Will it Last?

By Cristina Merrill | October 11 2011 11:21 AM

California insurers will soon be required to cover autism therapies under a new law, but whether that law will last under national health reform remains to be seen.

Reuters

Overall, the connection between diabetes in a mother and her child being diagnosed with autism was not significant, but the researchers did find links between a mother being obese or having any other metabolic condition and her child having autism.

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Governor Jerry Brown signed a bill into law which will require health plans and insurers to provide behavioral health treatments for individuals with autism and pervasive developmental disorder, according to a letter he wrote to the State Senate.

The law will go into effect on July 1, 2012 and expire in two years, according to the governor's letter.

Organizations such as the California Association of Health Plans (CAHP) are against the legislation. They do not believe that certain autism treatments, such as some therapies, count as medical treatment, The Associated Press reported.

SB946 is going to drive up health care costs for families and businesses by nearly $850 million a year by transferring responsibility for educational services to health insurers, the CAHP said in a statement, The AP reported.

The Centers for Disease Control and Prevention (CDC) note that autism treatments fall into four categories: behavior and communication approaches, dietary approaches, medication, and complementary and alternative medicine.

The CDC notes that there is no one best treatment for kids with autism spectrum disorders.

Some children respond well to one type of treatment while others have a negative response or no response at all to the same treatment, the CDC says on its Web site.

Whether this law will hold up under national health reform remains to be seen.

In his letter to the State Senate, Brown wrote: Under national health care reform, the federal government will establish 'essential health benefits.' If the coverage established by this bill is not included as an essential benefit, the mandate of Senate Bill 946 will automatically expire.

Senate president pro tem Darrell Steinberg lauded the law's passage.

For many families this therapy is the difference between a hopeless outlook and a light at the end of the tunnel, Steinberg said in a statement. Thousands of California families have been forced to pay out-of-pocket or rely on taxpayer-funded programs for behavioral health treatments, which can cost $50,000 a year or more.