Families caring for children with autism often have health insurance. However, most of these health insurance plans do not cover autism treatment. Most Nebraska insurance companies and other Nebraska employee benefit plans do not currently cover autism therapies. In fact, most insurance companies designate autism a diagnostic exclusion. That means that no autism specific services are covered.

Initiatives are currently underway in Nebraska to change Nebraska insurance laws. These changes would require private health insurance policies to cover the diagnosis and treatment of autism spectrum disorders. They specifically require insurers to provide coverage of evidence-based, medically necessary treatments including behavioral therapies, such as Applied Behavioral Analysis (ABA).

The trend for healthcare for children with autism is sweeping the country and this is promising for those states who do not have insurance coverage for children with autism.

Where do the state initiatives stand?

• 26 States have enacted Autism Insurance Reform Legislation
• 12 States have Autism Insurance Reform Bills passed by the legislature and are awaiting enactment into law by the governor.
• 10 States are currently pursuing Autism Insurance Reform (including Nebraska)
• 4 States are not currently pursuing Autism Insurance Reform

Autism Speaks defines eight compelling arguments defining the justification for Autism Insurance Reform:

1. Mandated private health insurance coverage will provide services that are desperately needed by children with autism, who have greater health care needs than children without autism.
2. Treatments for autism are difficult to access, often inadequate, and frequently delayed. Denied coverage by private group health insurance companies, parents are often forced either to pay out-of-pocket or forego the treatments their children need.
3. Mandated private insurance coverage will bring effective autism services within the reach of the children who need them. The efficacy of Applied Behavior Analysis (ABA), the centerpiece of this legislative mandate’s benefits, has been established repeatedly.
4. Government and scientific organizations have endorsed Applied Behvior Analysis (ABA) and other structured behavioral therapies.
5. To combat the difficulty many families face in accessing Applied Behavior Analysis (ABA) and other structured behavioral treatments through public insurance, three states have passed autism insurance mandates that specifically require private insurance companies to provide coverage of these therapies, thus creating a public-private partnership for the provision of care.
6. The costs of the proposed benefit are small and will have very little impact on the cost of health insurance premiums for the individual consumer.
7. By improving outcomes for children with autism, mandated private insurance coverage will decrease the lifetime costs of treating and providing services and will actually result in an overall cost savings in the long-run.
8. Without passage of legislation requiring private health insurance coverage for autism, the costs associated with autism will continue not only to affect families, but will have far reaching social effects as well.

Click here to read the full report "Autism Speaks, Arguments in Support of Priate Insurance Coverage of Autism-Related Services, February 2009."

To learn more about the grass roots efforts for Autism Insurance Reform in Nebraska, click here.