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Insurers Balk at Paying for Autism Therapy

Schools now foot the bill, but advocacy group pressing for change

By Harry Kimball,  Newser Staff

Posted Sep 16, 2008 6:33 PM CDT

(Newser) – A national autism advocacy group is pushing insurance companies to pick up the tab for intensive new therapies now footed by local school districts, the Boston Globe reports. They say the rising number of autism cases will swamp school budgets and make it unlikely that kids will get the help they need. On the flip side, pushing insurers into the education business will “drive up costs for everyone,” says an industry rep, who adds that the therapies—which can run $100,000 a year—are still unproven.

Parents of autistic kids are angry that autism is still treated as a learning disorder. “If my son couldn't hear and needed a cochlear implant,” one said, “we wouldn't be asking the school system to take responsibility. Jack was diagnosed by a neurologist, not a schoolteacher.” Autism Speaks, the largest advocacy group, is pushing legislation in 20 states to require insurance companies to pay up.

Graphic compares the number of autism and mental retardation cases in the U.S., and also shows all disabilities.
Graphic compares the number of autism and mental retardation cases in the U.S., and also shows all disabilities.   (AP Photo)
Eight-year-old Charlie Blakey, who was diagnosed with autism at age 3.
Eight-year-old Charlie Blakey, who was diagnosed with autism at age 3.   (AP Photo)
Jacob Day, 3, who is autistic, studies a flash card held by his instructional assistant at his home.
Jacob Day, 3, who is autistic, studies a flash card held by his instructional assistant at his home.   (AP Photo)
Instructional assistant Jessica Reeder, left, congratulates Jacob Day, 3, who is autistic, for correctly completing a task at the Day home in Antelope, Calif.
Instructional assistant Jessica Reeder, left, congratulates Jacob Day, 3, who is autistic, for correctly completing a task at the Day home in Antelope, Calif.   (AP Photo)
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In a sense, it's asking for a blank check for therapies that we'd want more evidence to prove are really effective.
- Dr. Marylou Buyse, Massachusetts Association of Health Plans, on ABA

As a society, we have to acknowledge that autism crosses a line from an educational issue to a medical one. Jack was diagnosed by a neurologist, not a schoolteacher. - Judith Ursitti, mother of an autistic child

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