On Friday November 18th Dr. Huckabee joined a group of individuals including other professionals and parents from the autism community to testify at the capitol in support of treatment for autism being included in the Essential Health Benefits package. Essential Health Benefits are the benefits that must be provided by certain insurance plans purchased through the competitive marketplaces created under the new healthcare reform law starting in 2014 (www.ncsl.org). While many families have health insurance, most insurance policies exclude any treatments for autism as a covered benefit. If successful, the bill will require that all autism treatments and services be included in the Essential Health Benefits” package under the Patient Protection and Affordable Care Act (PPACA).
Autism Speaks has worked on enacting insurance reform laws nationally and in 2009 the Health Insurance Mandated Autism Treatment Law (HIMAT) was passed. The HIMAT law requires private group health insurance policies regulated by the Colorado Division of Insurance to cover services to treat autism up to $34,000 a year (www.autismcolorado.org). While the HIMAT law covers many small group insurance policies, it does not cover individual policies or policies that are under an ERISA plan.
There are ten categories of Essential Health Benefits in the PPACA. Two categories that affect autism are the “mental health and substance use disorder services, including behavioral health” (1302(b)(1)(G)) and “rehabilitative and habilitative services and devices” (1302(b)(1)(G)) (www.gao.gov). In response to the second category, Autism Speaks along with 20 other national organizations formed the Habilitation Benefits Coalition. The coalition is fighting for the rehabilitative and habilitative services to be provided to individuals regardless of their condition or diagnosis (The White Paper – Autism Speaks). The bill would mandate insurance companies to allow these treatments to be covered by individual policies and ERISA plans as well as plans offered by state based exchanges.
For more information on Federal Health Care Reform and its effect on Autism see the links below.
http://www.autismvotes.org/site/c.frKNI3PCImE/b.6518557/k.5A3A/Federal_Health_Care_Reform.htm
- Autism Speaks
http://www.ncsl.org/default.aspx?tabid=21393
- National Conference of State Legislatures
http://autismcolorado.org/index.php/helpful-resources/himat
- Autism Society of Colorado
© Lindsay Van Dusseldorp