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Virginia House Panel Nixes Health Insurance for Autism


An eight-member subcommittee of the House Commerce and Labor committee voted to table a measure that would have required many Virginia employee health insurance providers to cover a treatment for children diagnosed with autism spectrum disorder. The measure, which was proposed by Sen. Janet D. Howell, D-Fairfax, had passed the Senate earlier.

The measure that failed to pass was a mere shadow of the original bill proposed by Sen. Howell, but even the watered down version could not get approved. Howell argued that the lesser bill, which was limited to children ages 2 to 6 and subject to an annual maximum benefit of $35,000, would have added less than 1 percent to the cost of premiums and would apply to only about 14,000 children in the state.

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But both insurance and business lobbyists fought hard against Senate Bill 464, protesting that the mandate would be too costly for businesses. Failure to pass the legislation leaves the burden of paying for the treatment, called applied behavior analysis (ABA), on the families of autistic children. ABA treatments cost about $30,000 or more per year.

Applied behavior analysis is an objective discipline and a treatment approach that is endorsed for its effectiveness in treating autism by the US Surgeon General, the New York State Department of Health, the National Academy of Sciences, and the American Academy of Pediatrics. The Center for Autism and Related Disorders notes that treatment approaches grounded in ABA are considered to be at the “forefront of therapeutic and educational interventions for children with autism.”

Virginia is one of 35 states that do not require health insurance providers to cover ABA treatments. One argument presented by some states is that ABA is educational rather than medical, and thus should not be covered by health insurance. Health insurers have noted that ABA is often provided by school districts, that it is utilized to teach social and academic skills, and that it does not directly treat medical symptoms frequently associated with autism, such as mood disorders.

Associated Press
Center for Autism and Related Disorders
Richmond Times Dispatch, Feb. 24, 2010