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Bill would require insurance companies to cover autism
By Michael Rich, UA Community News Service
February 05, 2008
Char Ugol trembled at the podium, a tear escaping her eye as she spoke to
reporters at the state Capitol about her son Steven losing the ability to
call her Mommy.
Steven had been diagnosed with a moderate case of autism two years ago at the age of 3. He had lost his ability to communicate and feed himself, and doctors told the Scottsdale mother that therapy was his only chance for recovery.
That's when the problems started, Ugol said. Her insurance didn't provide coverage for the disorder and she was left having to scramble to find a way to pay for the treatment her son so drastically needed.
Ugol isn't alone. The vast majority of insurance companies in Arizona don't offer coverage for autism.
In response to this lack of coverage, more than 30 autism activists and state Sen. Amanda Aguirre, D-Yuma, met at the Capitol earlier this week to voice their concerns to reporters and deliver a proposed bill to the Senate.
The bill, called Steven's law, would require that insurance companies in Arizona offer coverage for the diagnosis and treatment of autism spectrum disorder.
"Insurance companies will not do this on their own," Ugol said.
Autism spectrum disorder is a term that describes all the different degrees of autism, including autism, Asperger's syndrome and pervasive development disorder.
"It wasn't long ago that the medical community believed that autism was untreatable, but today research has proven otherwise," said James Adams, president of the Autism Society of America, Greater Phoenix Chapter, who also spoke at the press conference.
Adams' daughter was diagnosed with autism at the age of 5. She was unable to speak or interact with people, but he said that after two years of therapy, she has learned to speak.
With the latest treatment methods, there is about a 50 percent chance of recovery from the disorder, but in Arizona the recovery rate for people with autism is only 5-10 percent, according to Kirstin Woodburne, vice president of the Autism Society of America, Greater Phoenix Chapter.
Adams said the reason for the lower rate of recovery in the state can be attributed to the lack of quality care and treatment for the disorder.
"This bill is going to give kids with autism a chance," said Aguirre, the legislation's primary sponsor.
Rates of autism have grown in the past several years. The disorder used to affect about one in 5,000 but now it affects one in 150, said Matt McMahon, a joint-venture partner of the Southwest Autism Research & Resource Center, a nonprofit, community-based organization in Phoenix.
Because insurance companies in Arizona are not required to provide coverage, the state - through the Department of Economic Security - pays for the services for those who qualify.
The services include occupational, speech, music and habilitation therapies.
For children up to 3 years old, services are delivered through the Arizona Early Intervention Program, and for those 3 years of age and over, services are delivered through the Division of Developmental Disabilities.
In 2006, AzEIP paid out almost $6,000 per child, and in 2007 DES, which pays for the DDD program, reported an annual expenditure of $44.5 million related to services for approximately 5,090 individuals with autism.
"I strongly feel that having a child with special needs should not be cause for families to file for bankruptcy, lose their house or be cause for divorce," Aguirre said.
Ugol said the pediatrician who diagnosed her son told her that he would need therapy that teaches children with autism how to communicate, basic motor skills and how to get through life with the disorder.
Ugol said she was on a wait list for government help when she discovered the Center for Autism and Related Disorders in Phoenix.
The organization was conducting a research study, and Steven was lucky enough to get in, she said. The study looked at children's IQ levels as they progress through therapy.
When Steven was first diagnosed with autism, he was mentally labeled as being severely preschool delayed, but after some speech therapy, special education classes and eight months in the research program, Steven is on a par with pupils his age, his mother said.
Woodburne said that if the law is passed, its impact on insurance premiums to both employers and employees would equate to about an $18 increase per year.
Currently there are 20 states that have passed legislation that is similar to what is being proposed in Arizona, and nine other states are debating whether to adopt similar legislation.
This bill would apply to employers with 50 or more employees.
Ugol said her son was lucky to get the treatment he needed, but families cannot rely on luck to get treatment.
"Arizona families need to tell their legislators to pass this bill and so we can let those in need know that help is on the way," Ugol added.