Utah Looks to Pass Autism Insurance Bill Despite Opposition

Insurance companies in Utah are fighting a bill that would mandate coverage of up to $50,000 a year for early behavioral therapy for autistic children. Also known as Clays Law (named after 8-year-old Clay Whiffen who was diagnosed with autism and found success with behavioral therapy), the coverage would include one-on-one therapeutic instruction for at least 25 hours a week.

Thanks in part to heavy coaxing from Autism Speaks, several states are pushing to have the legislation passed. Utah, which has one of the highest rates of autism in the country, is successfully on board along with 8 states that already require coverage, and Nevada, which is expected to pass the bill soon.

But not all states wanted a piece of the action. Virginia, for example, sought coverage for children through age 21; however, the states Senate Commerce and Labor Committee cut it to age 6 and also noted that if Virginia was unable to find money to fund the coverage, it would not be provided for government workers.

In Utah, some insurance companies are not pleased because they will be forced to cover the bill for a treatment that theyre not sure will be effective. Because autism is diagnosed through observation rather than lab testing, diagnosis is viewed as reliable as other conditions covered in policies. Also, they note that the coverage would only affect 33% of those who are insured in Utah. However, it has been said that treatments, when successful, have resulted in up to 50 percent being indistinguishable from their peers.

Supporters of the bill hope that legislation will eventually pass nationwide. Because so many families are unable to cover $50,000-$75,000 in out-of-pocket costs for the expensive therapy, having autism treatment covered in their insurance policies may be their only recourse.

Do you think it’s fair for states to demand insurance companies pay for the treatment of autistic children?