Q: Is autism a big deal in Utah?
A: Yes! According to
a recent study from the Center of Disease Control, Utah leads the nation with
the highest autism rates. 1 in 47
children in Utah are affected by autism and if trends continue that number will
continue to rise. The national prevalence rate for autism is 1 in 88 .
Q: Why isn’t autism covered by health insurance plans?
A: In Utah, insurance carriers are not required to cover
autism under medical or mental health benefit plans. This allows insurance companies to deny
diagnosis, treatment, and on occasion basic medical coverage, for those with autism spectrum disorders.
Q: Can autism be successfully treated?
A: Yes - Autism is
treatable! Studies have shown that
individuals with autism who receive intense evidence based intervention and
therapy have 80-90% success rates at enabling people to manage the symptoms of
autism. Studies also show that 47% of individuals
with autism who received these therapies attained normal intellectual
functioning whereas only 2% of individuals with autism who did not receive
these therapies attained normal intellectual functioning. Basically, therapy can make the difference
between a nonverbal adult living on state assistance, to a verbal functioning
adult who has a job and pays taxes.
These stark differences are astounding and are real.
Q: Does it matter when kids receive autism treatments?
A: Yes! Although
individuals with autism can and do make improvements their entire life, the
earlier intense intervention and treatment are provided the better. This is why it is so important Utah pass
autism insurance reform now. The
sooner intense autism therapy is provided the better the outcomes. As prevalence rates increase, every year that
we wait will result in loss of functional capacity for individuals with autism and
an increased costs to society.
Q: How many states have passed autism insurance reform?
A: As of April 2012,
31 states have passed autism insurance reform.
These states include: Alaska, Arizona, Arkansas, California, Colorado,
Connecticut, Florida, Iowa, Illinois, Indiana, Kansas, Kentucky, Louisiana,
Maine, Massachusetts, Michigan, Missouri, Montana, Nevada, New Hampshire, New
Jersey, New Mexico, New York, Pennsylvania, Rhode Island, South Carolina,
Texas, Vermont, Virginia, West Virginia, and Wisconsin. Go to Autism Votes to learn more.
Q: Is autism insurance reform a partisan issue?
A: Absolutely not!
Autism affects everyone, no matter what the party. Autism insurance reform has been passed in
some of the most conservative states in the nation including: Texas, Arizona,
Louisiana, South Carolina, Alaska, and Arkansas to name a few.
Q: How much will my insurance go up if an autism
insurance mandate is passed?
A: According to data
from states with autism insurance coverage the average “per member per month”
(PMPM) premium increase was $0.15 the first year after implementation; that amount
rose to $0.31 the second year due to increased awareness and use of the autism
insurance benefit. $0.31 is a miniscule
amount, especially when the benefits of autism insurance coverage are so great.
Q: Will small business be forced to drop their insurance
plans if an autism insurance mandate is passed?
A: Absolutely not!
This is a scare tactic used by insurance lobbyist. There is no data from any of the 30 states that
have passed autism insurance legislation to support this claim. We back up our facts with data, it is time
insurance lobbyist do as well.
Q: Will autism insurance coverage help Utah’s economy?
A: Yes – in very exciting, sustainable ways. Autism insurance coverage will: bring new
meaningful jobs to Utah; save the state, and tax payers, millions of dollars
every year; and help those with autism become an asset to our community instead
of a financial burden.
Q: Why should autism treatment fall under medical
benefits instead of under education?
A: Autism is a medical condition diagnosed by medical
professionals. Evidence based autism
therapies like: Occupational Therapy, Speech Therapy, and Applied Behavior
Analysis (ABA) Therapy, are all medical treatments based upon medical
models. Teachers and schools are not
equipped with the necessarily time, training, or resources to provide medical
treatment for children with autism or any other medical condition. Educational programs are designed to
accommodate medical disabilities, but not to treat underlying medical
conditions. The treatment of underlying medical conditions is the
responsibility of qualified medical providers and not educators. Further, the
research available does not indicate that educational programs have demonstrated
effectiveness in treating the underlying medical condition of autism.
Currently the burden of treating kids with autism is being
placed on schools. Teachers, schools, and
school districts all across Utah can tell you they are getting into a crisis
situation trying to provide for kids with autism. Our already strapped education system cannot
provide the medical treatment autism kids need.
Schools are not required to treat any other underlying medical
condition; why would they be required to treat autism?
Q: What would be covered under autism insurance?
A: Until we have a bill in front of us it is impossible to
say exactly what will be covered. But,
following the basic model of what has successfully passed in 30 other states,
evidenced based therapies such as: Applied Behavior Analysis (ABA) therapy, pharmaceuticals,
psychiatric treatment, psychological treatment, occupational therapy, speech
therapy, and medical treatments, would be covered for individuals with Autism
Spectrum Disorder diagnoses who have health insurance policies regulated by the
State of Utah.
Q: I’ve heard autism insurance reform will only affect
1/3 of health insurance plans, is that true?
A: This is true. The
state of Utah regulates about 1/3rd of health insurance plans held
in our state, those plans include: small to medium group plans, and individual
plans. The other 2/3rd are
regulated by the federal government, those plans include: Medicaid, Medicare, military
plans, and large group plans.
With this said do not let the anti-mandate rhetoric of “it
only covers 1/3rd of people so it’s not worth it” fool you. We cannot stress enough the importance of an
autism insurance mandate versus some other kind of solution. First, the majority of middle class families
have health insurance plans that are regulated by the State of Utah. Second, historically it takes 35 states to
mandate a certain condition before the Federal Government follows suit. Lastly, if a boat is ship wrecked and you
only have life vests for 1/3rd of the drowning people would you
choose to throw them out because you couldn’t save everyone? It is imperative to Utah families health
insurance plans cover autism spectrum disorders.
If you have unanswered questions about autism insurance, please email them to us at utahautismcoalition@gmail.com.
