California Commission To Recommend Steps on Insurance Coverage For Autism

The California Blue Ribbon Commission on Autism issued a draft report that identifies private health insurance as a key concern and area for legislative focus in 2008. According to the report, numerous families throughout California identified problems with health coverage for autism.

According to the draft report, health plans may deny services for autism for reasons related to medical necessity that are at odds with medical science. Some private health plans have denied interventions on the basis that autism is a disorder of brain development that is present from birth and not amenable to medical treatments or interventions.

Another reason for denial of services by some health plans is that autism is a chronic disorder and therefore not amenable to acute treatments or cure. Such reasoning is perplexing and seems at odds with the coverage the health plans routinely provide for numerous other chronic illnesses (such as diabetes and/or congestive heart failure) that are also frequently incurable. The draft report observes that some private health plans may be inconsistent both with current scientific evidence as well as with standards and approaches that are applied to other illnesses and medical conditions.

The September 18th Blue Ribbon Commission meeting had a large turnout of parents who were very complimentary of the commission’s work to date. Over 15 representatives of Autism Speaks attended the meeting.

According to Robert Blitz, Autism Speaks San Diego Advocacy Chair, the recommendations on insurance are very much welcomed by the families with autistic children. Blitz stated that families in California often are going tens of thousands of dollars into debt and sometimes losing their homes in order to finance treatment even though they have private health insurance. According to Blitz, “if private health companies failed to provide coverage for Alzheimer’s or cancer because there was no acknowledged cure, there would be an uproar.

The Blue Ribbon Commission is expected to deliver its final report to the California legislature before the end of September.

FROM: AUTISM SPEAKS, SAN DIEGO CHAPTER
Robert Blitz – San Diego Advocacy Chair; autismspeaks@cox.net; 714-783-7295;autismspeaks@cox.net