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Calls to Action

Utah: New Year, New Bill, Same Goal

NEW YORK (February 1, 2013) -- Autism Speaks today formally endorsed S.55, the new Utah autism insurance reform bill, sponsored by Dr. Brian Shiozawa, a Salt Lake Republican Senator and past president of the Utah Medical Association. Utah has the highest incidence of autism in the nation, yet is one of only 18 states not to require state-regulated health plans to cover the diagnosis and treatment of autism. 

The Shiozawa bill would cover applied behavior analysis (ABA) up to $50,000 a year for children through age 8, then up to $25,000 a year though age 17. The bill would take effect July 1 of this year.

“"We commend Senator Shiozawa for his leadership on this issue of critical concern to thousands of Utah families in urgent need of insurance coverage,"” said Lorri Unumb, Autism Speaks vice president for state government affairs. “"Autism Speaks joins Utah's autism community in calling on the legislature to pass S.55 and join the growing majority of states that have ended healthcare discrimination against children with autism."”

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.)

An autism insurance reform bill enacted last year created a test state program for about 300 children funded through state Medicaid funding and voluntary contributions from the private sector. The Utah Autism Coalition has estimated over 18,000 Utah children have autism.

According to reports in The Salt Lake Tribune, the Medicaid program was hindered by low reimbursement rates which limited the number of providers, while the private sector contributions were slow to materialize. In the meantime, it cited 20 cases of parents surrendering their children to the state because they could not afford to provide them the autism treatments they needed.

Shiozawa's bill would require state-regulated health plans to cover the diagnosis and treatment of autism, including speech, occupational and physical therapy as well as pharmaceutical benefits.

Small businesses would be granted a waiver if they can demonstrate the autism coverage increases their premiums over 2.5 percent over a 12-month period. Actual experience in other states which have enacted autism insurance reform shows the impact has been under 1 percent.