New Jersey Bill Requires Autism Treatment Insurance Coverage
Here at AutismOne we hear a constant stream of stories of families facing financial disaster due to high cost of caring for an autistic child. A primary culprit pertains to insurance. In many cases health insurance simply is not available that covers autism or else the premiums are so high as to be prohibitive. Fortunately, individual states are stepping in with legislation requiring health insurers to pay for autism diagnosis and treatment. The Autism Bulletin describes 17 States that require some level of insurance coverage for autism services (refer to the link at the end of this article).
The latest victory in this respect is in New Jersey. Recent articles in a number of publications highlight the State’s action. For instance, the New York Times article “NJ Expands Health Insurance Coverage for Autism” and the news site Philadelphia Business Today article “N.J. bill would require autism-treatment coverage” provide an insight to the State’s actions. (Refer to the links at the end of this article for access to these sites.)
According to a study by the Centers for Disease Control and Prevention (one of the 13 major operating components of the United States Department of Health and Human Service) New Jersey has the highest autism rate of any state in the country. Recent studies have found that 1 in 94 of New Jersey children have autism, compared with 1 in 152 nationwide. So New Jersey took the bull by the horns and became the 15th state to approving a bill requiring health insurers to pay for diagnosis and treatment of autism. The bill recently signed by Governor Jon Corzine was championed by New Jersey Assembly Speaker Joseph Roberts who said the new law ''mandates that health insurers do the right thing.''
This bill provides a first step forward even though it is limited in scope. That is, the insurer’s liability is capped at $36,000 per year and only includes patients under age 21. But it does cover diagnostic services and behavioral early intervention, as well as occupational, physical, and speech therapy.
As might be expected the bill saw strong opposition from health insurers and others (for instance, the New Jersey Business and Industry Association and New Jersey Association of Health Plans) who feared that the bill would drive up health care costs. The NY Times article says: “Roberts, however, said the opposite is true. With early diagnosis and treatment, he said, more children can receive mainstream educations, which cost about $13,000 per year per pupil, compared with about $50,000 a year for special needs students.” Roberts referred to a UCLA study that showed “47 percent of autistic children who received early behavioral treatment went on to be "indistinguishable from their peers" and started elementary school in mainstream classes.” (Quoted from Philadelphia Business Today article).
Further testimony described a 2006 study by the Harvard psychologist Michael Ganz. In the first ever study of the societal price of autism, the lifetime cost of caring for a person with autism was estimated to be about $3.2 million. This brings to mind a TV automobile transmission commercial of previous years by the actor Claude Akins: “You can pay me now or your can pay me later.” Of course, the message was “pay a small amount now for regular transmission servicing or pay me much more later for a transmission overhaul.”
You can read the original articles by clicking the appropriate link:
NY Times New Jersey article
Philadelphia Business Today New Jersey article
Autism Bulletin article
NY Times New Jersey article
Philadelphia Business Today New Jersey article
Autism Bulletin article
Then come back and enter your opinions by adding a comment (click “Add new comment” link below). Alternately you can enter a blog. Be sure to read the Autism Bulletin article and its ensuing comments. See what your State is doing. Many of the laws are vague and/or include significant loopholes. Let you legislators know your opinions.
As a financial adviser life
As a financial adviser life insurance is a major piece of my practice. A few years ago I gave my new nieces and nephews what I call, "The Gift of Life". Insurance carriers will allow you to purchase life insurance after 14 days of birth. I always recommend this for all my clients in purchasing a small whole life insurance companies policy of $25,000. Typically the premiums run about $14.00 per month and about age 36 they should vanish if you purchase this from a Mutual Insurance Co. This will be with about every insurance carrier in the market. Unfortunately most don't really think about this. Sidebar** My little nephew was just diagnosed with Autism. Who would have guessed? He now has a whole life policy and I will execute the Waiver of Premium for disability and the premiums will be paid in full until age 65. Now I have built a nice nest egg for this little guy that he will have at retirement. Just transfer the ownership of the life policy to a "special needs trust" and, Whala... Magic.