(May 29, 2014) -- Families facing expensive autism treatments are finding some positive results in New Jersey's implementation of the Affordable Care Act (ACA), according to an article published today on NJ.com.
The main focus of parental concern is payment for Applied Behavior Analysis, or ABA, therapy. In such sessions, an ABA specialist instructs the child on the basics — recognizing objects, learning to point, using scissors or makinng eye contact — by laborious repetition.
“With some kids, that requires really intensive services,” Autism Speaks' director of state government affairs Judith Ursitti told NJ.com.
The ACA prohibits yearly and lifetime dollar caps on essential health benefits, including behavioral therapy and habilitative services. As a result, a $36,000 annual cap on ABA benefits in New Jersey's 2009 autism insurance reform law was voided.
“New Jersey is one of the few states that have said these dollar caps are illegal under federal health care parity,” Ursitti told NJ.com.
Insurance carriers in other states are attempting to get around the prohibition on dollar caps by converting them into limits on the number of visits.
“It’s ridiculous,” Ursitti said. “It’s a cap.” In some cases, she said, plans have limited coverage to eight hours of treatment a week.
Read the full article here.
Learn more about the ACA and autism here.