WASHINGTON, DC (October 19, 2012) -- In a strongly worded letter to U.S. Secretary of Health and Human Services (HHS) Kathleen Sebelius, four U.S. Senators said the federal government is not doing enough to require the states to include behavioral health treatments, such as ABA, as part of national health care reform.
Authored by U.S. Senators Kirsten Gillibrand (NY), Barbara Boxer (CA), Al Franken (MN), and Sherrod Brown (OH), all Democrats, the letter urged HHS to require all health care plans to cover autism treatment by 2014. HHS last December released guidelines that could allow the states to decide whether or not to include autism care in statewide health plans. The guidance was issued as states designate benchmark health plans covering 10 essential health benefits as required under the 2010 Affordable Care Act.
In their letter, the Senators said, "Rather than setting a uniformly high national standard, the [HHS] guidance allows states to select benchmark plans that neglect or skimp on autism care… If the guidance is not changed, children and adults with autism will not be better off when Affordable Insurance Exchanges launch in 2014 than they are today…
" Congress recognized autism as a top national health priority," the Senators wrote. "We intended not to preserve the status quo, but to reduce the burdens faced by families across the nation. In finalizing the guidance for the essential health benefits, we urge you to clarify behavioral health treatment as including ABA for individuals on the autism spectrum.”
Currently, 32 states have enacted autism insurance reform requiring some level of coverage for ABA. But those states, as they implement federal health care reform, can choose benchmark plans that provide only a portion of ABA coverage. The HHS guidelines would require the 18 states that lack autism insurance laws and the three states that enacted autism insurance laws in 2012 to defray the cost of any ABA coverage.
The Senators called for a uniform federal standard, regardless of one’s health insurance plan or state insurance law, to ensure that all families ave access to affordable treatment.