Autism Insurance Reform Bill Awaits Snyder's Signature

Families with autistic children will remember 2012 as a big step forward for helping their young.

Recently Michigan lawmakers approved bills that will require insurance companies to offer autism treatments; now they await one last signature from Gov. Rick Snyder. It’s projected he’ll sign the bills mid-month—perfect timing, since April is Autism Awareness Month.

After that, insurance companies will have 180 days to comply with coverage requirements; it then should take effect with annual insurance renewals.

The news is especially welcome, considering that the Centers for Disease Control and Prevention (CDC) recently announced that one in every 88 children has been identified with an autism spectrum disorder (ASD). That’s up from 2006, when one out of every 110 children was affected. (Learn more at www.cdc.gov/ncbddd/autism/data.html.)

“A 7-year endeavor came to fruition on March 29,” says Stacie Rulison, a St. John resident who worked hard in getting the legislation approved.

Rulison is an independent consultant for and operations director for the Autism Alliance of Michigan (AAOM), and a behavior therapist with Henry Ford Health System. Being the mother of an autistic boy especially motivated her. She’s quick to add she was far from alone in the effort.

Rulison says Lt. Gov. Brian Calley and David Meador, executive vice president and CFO of DTE Energy, and treasurer/secretary and co-founder of AAOM—both fathers of autistic children—used their visibility and connections to stump for the laws.

“He saw a real void there,” Rulison says of Meador’s struggle to get treatment for his child. 

In terms of coverage, she says “you have benefits before diagnosis, and then you lose them.” Therapy—Applied Behavioral Analysis (in brief, studying how learning takes place) plus occupational, speech, physical and behavioral treatments—has proved to work. Rulison says when her son, now 7, started therapy it was difficult to get two words out of him; now he’s mainstreamed and in school.

Parents, to help their autistic children, have invested huge amounts of money and time. Now with coverage for these therapies—some parents may still have to lobby insurance providers, however, to ensure coverage -- it will be a huge boost for parents and their children.

Theresa Gabalis, president of the Macomb/St. Clair County chapter of the Autism Society of America, has a 16-year-old son with autism. “When Scott first was diagnosed,” she says, “it would have been great to have (coverage).” The Chesterfield Township resident says her family has literally spent thousands of dollars “out of pocket” for treatment, which is especially important for the young, since that’s when it can do the most good.

Scott’s not in therapy anymore, so the law won’t really impact him, but Gabalis sees it as “the right thing to do ... kids with autism have basically been ignored.” She knows of families who have taken second mortgages on their homes, to pay for treatment. It gets especially pricey, she says, when some children need 20, 30 or 40 hours of therapy a week. Each case is unique, she and Rulison add, since the spectrum is so broad, from very mild to severe.

Gabalis likens treating autism to managing diabetes: With early intervention and treatment, it becomes all the more manageable.

In addition to helping families and children, Rulison and Gabalis see other benefits, including keeping ABA therapists in Michigan. Many can’t justify staying in state, since their services weren’t covered by insurance companies. This legislation should change that, likely creating new jobs. It will also help families’ pocketbooks.

“It’s the first step to helping thousands of families,” says Rulison.

While Gabalis and Rulison don’t see this move as a fix—more work is required terms of working with insurance companies, consulting with doctors, schools and raising awareness—they do see it as a great start.

 “Ten years from now,” Gabalis says, “you’re going to see the results.”
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Senate Bills 414, 415 and 981. http://www.legislature.mi.gov/
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On the web: Just as autism is a complex disorder that is a long way from being fully understood, there is plenty of information available. Visit these sites to learn more about autism itself, therapies, special events, fundraisers, advocacy groups, and more:

• Autism Alliance of Michigan: http://autismallianceofmichigan.org/
• The Macomb/St. Clair County Chapter of the Autism Society of America: www.macombasa.org. Visit their Facebook page for more news on activities.
• Autism Speaks: www.autismspeaks.org
• Autism Votes: www.autismvotes.org