Children With Autism In Illinois To Have Health Insurance Coverage

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Gov. Blagojevich uses amendatory veto to expand House Bill 4255 requiring health insurance companies in Illinois to also cover a range of autism treatment for youth until the age of 21.

Governor Rod R. Blagojevich today used his amendatory veto power to expand House Bill 4255 to require insurance companies to cover autism diagnosis, occupational therapy, physical and speech therapy, psychiatric and psychological services and applied behavioral therapies. Insurance policies will be required to cover up to $36,000 a year and an unlimited number of visits for kids with Autism Spectrum Disorder until age 21.

The amendatory veto will keep the original language of HB4255, a bill to require public employee health plans to cover preventative physical therapy treatments for multiple sclerosis, but will add the autism coverage language from Senate Bill 1900, a bill that did not pass the General Assembly this Spring despite broad bipartisan support.

“Since most insurance companies do not cover the cost of treating autism, families can be torn apart and sent to the brink of financial ruin trying to care for their child,” said Governor Blagojevich. “I am amending this legislation because insurance should never be an obstacle to children reaching their potential.”

“As of now, we’re basically uninsured for the country’s number one medically-diagnosed children’s disease because insurance companies deny us access to critical health insurance coverage,” said Peter Dicianni, lead advocate for SB1900, and whose insurance does not cover his daughter’s Brianna treatment for autism.

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Approximately 26,000 children in Illinois have been diagnosed with Autism Spectrum Disorder and families with autistic children often have to cover the cost of treatment using personal funds. Currently, only people in large group insurance policies (50 or more beneficiaries) can get coverage for children with autism, and even then can only get inpatient and outpatient mental health services. This change will require all insurance policies to cover costs for diagnosis and the therapies children with autism need to improve their communication and social skills, and live independent lives.

“As sponsor of this bill, I’m glad to know that families dealing with expense of covering the costs of multiple sclerosis and autism know that they are not alone” said State Representative Robert Pritchard. “The State of Illinois is in their corner and fighting with them to make sure their children are able to minimize the effect of autism on their lives.”

“Children need all the help they can get to grow up into educated, balanced adults,” said State Senator James DeLeo. “If a child is struggling with autism, they need extra love, attention and specialized care. This bill will help ensure they get that extra help.”

While the underlying cause of autism is unknown, medical experts agree that early intervention helps affected children improve their communication and social skills, enabling them to live independent lives, and in many cases, be indistinguishable from their peers. Children who do not receive appropriate intervention have a less than 2 percent chance of living a normal life.

“The Governor and the members of the General Assembly are dedicated to improving the quality of life for children with autism,” said State Representative Angelo “Skip” Saviano. “Through the passage of this bill, we will make sure that Illinois’ families get the help they need.”

“I’m pleased that this autism bill is being passed in Illinois,” said State Senator Terry Link. “Many families struggle and try to help their children deal with this often misunderstood disorder. Now they know that lawmakers in Illinois care and are working hard to help turn their tragedy into triumph.”

The original language of HB 4255 made changes to the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, and the School Code to require public employee health plans to cover medically necessary preventative physical therapy for insureds diagnosed with multiple sclerosis.

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