2011 Changes in Insurance Coverage of ABA Therapy for Autism

This month marks an exciting change in insurance coverage for applied behavior analysis therapy in the treatment of autism for many states. Starting on the first of the year, Iowa, Kansas, Maine, Massachusetts, Missouri, Nevada, New Hampshire, Kentucky and New Jersey began requiring certain state-regulated insurance companies to cover ABA. With Vermont’s legislation towards autism treatment taking effect July 1, 2011, insurance coverage for ABA therapy now spans nearly half the country.



On January 27^th, the House Commerce and Labor Committee voted in approval of similar legislation, with the aim of striking "a balance between the needs of the business community and families with autistic children." The needs of the business community are pretty clear: make it cost-effective! With the lifetime cost of care for an autistic individual estimated at a whopping $3.2 million, we can assert that the upfront absorbed cost of ABA therapy—while intimidating—will help to assuage this long term expense. Families of autistic children seeking ABA treatment are undoubtedly thrilled with this progress.



So everyone’s happy, right? Well, almost. Autism doesn’t discriminate by location, and unfortunately there are still many states without mandated insurance coverage for treatments like ABA—where it’s not expected to happen for several years. On the blogosphere, parents of young, autistic children publically lament this fact and discuss relocating their families to other states where ABA is subsidized, sacrificing great jobs and proximity to loved ones in so doing. Due to any number of logistics, many can’t just move and confess to feeling in a race against time, since ABA is known to be most effective as an early intervention. And it’s not just about optimum timing for efficacy—most insurance coverage for ABA treatment is limited to those between two and six years of age.



We’re making great strides in the treatment of autism spectrum disorders, January’s achievements notwithstanding. But it’s hard not to reflect upon what it took to get here, and how much longer it may take to get even further. This past December in Michigan, despite earnest grassroots efforts, the legislation supporting for autism treatment coverage didn’t even make it onto the Senate floor. How many children might miss a crucial window of opportunity while waiting on the sidelines of, say, Detroit?