A Grateful Nation
by Blair Hughes and Karen Driscoll. Hughes is the wife and full-time caregiver of a Wounded Warrior and mother to three children, one with autism; she serves as a Caregiver Fellow with The Elizabeth Dole Foundation. Driscoll, Autism Speaks' associate director of federal government affairs and military relations, is a Marine Corps wife and mother of three children, one with autism.
As military spouses, we appreciate this Veterans Day and our country’s strong and sustained support for our troops and their families. But as mothers of children with autism, we also raise a concern that goes to the heart of military readiness and our nation’s moral obligation to the 23,000 families dealing with this disability.
Our issue? Our military healthcare program, TRICARE, limits coverage of behavioral health care for autism and maintains policies inconsistent with best practices, severely restricting access to care. Covered services are meager at best and disappear once the military member retires from active duty. Incredibly, this includes Wounded Warriors who lose autism benefits for their children entirely when they are medically retired from service.
A Wounded Warrior's autistic child could have been receiving years of proven therapy while the service member was on active duty, only to have the rug pulled out from under them at a time when they need stability and therapy most. Is this how we treat our nation’s heroes? We can and must do better.
Advocacy efforts (led by military spouses here on the homefront) that have taken years to coalesce now stand on the threshold of success in Congress and in the courts.
Members of Congress led by Representatives John Larson of Connecticut, Walter Jones of North Carolina, and Senator Kirsten Gillibrand of New York have taken our cause to heart. Bipartisan legislation improving coverage of autism care passed the House and now awaits Senate action. At the same time, a federal court this summer ruled in favor of military families and action is working its way through the judicial system. But the time for this Congress to act is short, and the legal process is uncertain.
What drives the legislation and the litigation is the same -- the moral urgency to provide our nation’s military families the health care they have earned and deserve. Data from the national Centers for Disease Control confirms the prevalence of autism has soared over 600 percent in the past two decades and now affects 1 in every 88 American children, including 1 in every 54 boys. The rising prevalence of autism knows no boundaries and also extends to our military children. Military families directly impacted by autism draw a spotlight on the promise our country and its leaders have made to care for our military families back home.
While the cause of autism remains unknown, what we do know is that behavioral health treatments, such as Applied Behavior Analysis (ABA), greatly improve a person’s life outcome and are the cornerstones of autism treatment. Shown to improve communication, social skills and daily living functions while reducing the disabling symptoms of autism, ABA has been widely accepted by the medical community and is endorsed by the American Academy of Pediatrics. Regrettably, TRICARE does not recognize ABA treatment as medical care and severely restricts coverage.
TRICARE’s position is inconsistent with public policy. In fact, our civilian counterparts in the federal workforce will be able to access ABA coverage starting in 2013 as a result of a recent decision by the U.S. Office of Personnel Management that ABA for autism is indeed a "medical therapy.” In addition, 32 states (representing 75 percent of the U.S. population) have enacted laws requiring private insurers to cover ABA. Increasing numbers of self-insured major employers are voluntarily offering the benefit. Unfortunately, these developments do not extend to the military family. We need a separate fix.
If we are to maintain a quality all-volunteer force and meet our promise to care for our military families, the disparity between TRICARE and public policy must be addressed. Just as we would not leave any service member behind on the battlefield, we should never leave a military child behind. Leadership at the highest levels is needed to ensure smart policies are implemented without delay.
Our nation is grateful for its veterans and military service members. The last thing our military service members should have to do is fight for basic medical services for their families. On this Veterans Day, we call on our nation’s leaders to provide the quality of care to our veterans and military families that is equal to their heroic service and sacrifice. It is simply the right thing to do.