House Passes Autism Insurance Legislation

New Law Requires Health Insurance Companies to Cover Diagnosis, Treatment for Autism Spectrum Disorders

State Representative Paul J. Donato (D-Medford, Malden) joined his colleagues in the Massachusetts House of Representatives in passing legislation requiring health insurance companies to cover the diagnosis of and treatment for Autism Spectrum Disorders.

“With more and more Massachusetts families confronting autism, this bill will provide needed relief for families dealing with medical costs as a result of treating this disorder,” House Speaker Robert A. DeLeo said.

“Today is a historical day in Massachusetts, following in the footsteps of other states that have implemented autism medical insurance coverage,” said State Representative Barbara L’Italien (D-Andover), the lead sponsor of the legislation. “Experience data in Minnesota show that Blue Cross and Blue Shield have been covering autism services for six years at 83 cents per person per month. I am proud of my House colleagues for passing the Autism Insurance bill, striving to make Massachusetts the 23rd state to provide coverage for persons with autism. We have taken steps to transform lives today by providing services and treatments to all individuals on the spectrum, not just those that can struggle to afford it or who fall under the protection of the Commonwealth.”

“Once again the Massachusetts House of Representatives has passed legislation to provide care for some or our most vulnerable citizens,” said Representative Donato. “I am proud to support this bill.”

“This is expected to provide much-needed services that are currently financially out of reach for many families, and help those with autism receive the support they need which helps their quality of life as well as saving the state in reduced services required down the road through better early interventions and therapies,” said State Representative Carl Sciortino (D-Medford, Somerville).

The legislation provides coverage for habilitative or rehabilitative care, psychiatric, therapeutic, pharmacy and psychological care for all individuals with autism.

An independent study done by the Commonwealth’s Division of Health Care Finance and Policy found that the anticipated increase for expanding coverage would be $1.84 per member per month. Cost estimates indicate that, over the course of a person’s life, care relating to autism will cost approximately $3.2 million. This cumulative cost has been a financial burden not just on families, but also on the Commonwealth through Early Intervention services and other state-funded programs.

Autism affects 1 in 110 children or 1.5 million Americans nationwide. In 2011, it is estimated that nearly 700 children in Massachusetts will be diagnosed with this disorder that impacts one’s ability to interact socially, communicate effectively, and sometimes can leave an individual physically impaired and completely incapable of speech.

Governor Patrick signed this legislation on August 3, 2010 and it is now Chapter 207 of the Acts of 2010.

– Information from State Representatives Donato and Sciortino