SALT LAKE CITY (February 14, 2014) -- The 2014 Utah autism insurance reform bill is headed to the Senate floor following passage today by the Senate Business and Labor Committee on a 6-1 vote. Utah has the highest prevalence of autism in the nation, yet is one of only 16 remaining states yet to bar insurers from refusing to cover basic therapies on the basis of an autism diagnosis.
Sponsored by Sen. Brian Shiozawa, the bill, SB.57, would require state-regulated health plans to cover applied behavior analysis (ABA) treatment for autism up to $36,000 a year for children through age 8, then up to $18,000 a year though age 17. The bill mirrors a coverage plan Salt Lake Mayor Ben McAdams proposed for county employees in his 2014 budget proposal.
In addition, coverage would be required for speech, occupational and physical therapy, as well as pharmaceutical benefits.
Small businesses with fewer than 50 employees would be exempt from providing the coverage if they could demonstrate it raised the cost of their health plans by 2.5 percent or more. A new study in Missouri showed the impact of its autism insurance reform law during 2013 on total health care costs was 0.2 percent.
According to a 2012 Centers for Disease Control study, 1 in every 47 Utah children has autism, the highest rate in the nation and significantly higher than the 1 in 88 national average. The University of Utah calculated that between 2002-2008, autism prevalence increased twice as fast in Utah than nationally (157 percent versus 78 percent.)
The 2014 bill marks the third attempt in three years Utah legislators have taken on the issue. Jon Owen, president of the Utah Autism Coalition, relates in a blog how his son Ben's autism diagnosis led to insurance claims getting rejected "for anything from well-child visits to a broken arm."
Andrea Griggs of Murray reported how paying the cost of just one year of ABA therapy for her son Jaxon forced her family to sell their home and downsize to a house half the size. Her family's insurance also refused to cover treatment because of Jaxon's autism diagnosis.