Nj bill on Autism insurance closer to becoming law

BRUCE SHIPKOWSKI
The Associated Press

TRENTON, N.J. - A measure that would expand health insurance coverage for autism and other developmental disabilities in New Jersey may soon become law.

The bill requires insurers to cover the cost of autism treatments deemed medically necessary, such as physical, speech and occupational therapy, along with behavioral intervention. The Assembly overwhelmingly passed it Thursday.

That came a week after the Senate approved the measure, which would cap coverage at $36,000 annually for patients ages 21 and younger.

The bill now heads to Gov. Jon Corzine, who is expected to sign it into law soon. If that happens, New Jersey would be the 14th state with such coverage requirements.

"Families that have a loved one with autism should not be expected to shoulder the financial hardships of this disorder alone," said Vincent Prieto, D-Secaucus, who co-sponsored the bill with Assembly Speaker Joseph Roberts Jr., D-Brooklawn, and Assemblywoman Joan Voss, D-Fort Lee.

"Requiring health insurers to cover therapies for autistic children early in their lives ensures they receive the treatments they most need when it will make the greatest impact," Prieto said.

A Federal Centers for Disease Control and Prevention study found that 1 in 94 New Jersey children have the disorder, compared with 1 in 152 nationwide.

Autism is considered a genetic-based disorder. Its cause has not been pinpointed and there is no known cure. The symptoms are wide-ranging and include poor speaking and eating abilities, self-inflicted injuries and inappropriate crying or laughing, according to Autism New Jersey.

"Treating autism spectrum disorders early ensures that these children learn basic life skills, which can have lifelong impacts, often mitigating some of the challenges faced by many adults with autism," Voss said.

Some people with autism have trouble learning how to do the simplest tasks, and supporters of the measure say insurers often do not cover needed treatment, or if they do, the coverage is for a limited time. Opponents, while sympathetic, contend it will drive up health care costs for small businesses.

N.J. Senate committee advances bill expanding coverage for autism therapy

by Elise Young/Statehouse Bureau
Monday June 15, 2009, 6:33 PM

TRENTON -- Health insurance would cover treatment costing up to $36,000 a year for New Jerseyans with autism and other developmental disabilities, under a bill that cleared a Senate committee today.
Twelve states have approved such a law to cover behavioral, occupational, physical, speech and other therapies that insurers sometimes deny because they are not considered restorative. New Jersey would cap the coverage at $36,000 for 2011, and adjust the figure for inflation each year.

The measure was approved by the Senate Budget and Appropriations Committee today and will now head to the full Senate for final legislative approval. The Assembly passed it about a month ago.

"More and more states are recognizing the need to pass this legislation," Stuart Spielman, a policy adviser and counsel to Autism Speaks, told the committee. "Given the severity of autism spectrum disorders for many people, providing comprehensive care is the best way . . . to realize savings down the road."

New Jersey has the country's highest rate of autism, with one in 94 children affected, according to the federal Centers for Disease Control and Prevention. Nationwide, the average is one in 150 children.

Autism affects an individual's ability to communicate and socialize. Its symptoms can be barely noticeable to completely debilitating, and it has no known cure or cause, although genetic and environmental factors may contribute.

Some of the treatments entail expensive, evolving therapies that work well for some, but don't work for others. During past legislative hearings on the bill, some parents described depleting savings to pay for care for which they were not reimbursed by their health plans.

One treatment involves "teaching" a person with autism to identify a companion's emotions -- smiling, for instance, or crying -- and reacting appropriately. Others aim to redirect compulsive behavior, such as banging one's head.

"The committee should be applauded for recognizing this legislation as an incredibly sound and compassionate investment," Assembly Speaker Joseph Roberts (D-Camden) said in a statement. "The greatest cost would be the cost of doing nothing, not only for those trying to break through these disorders and their families, but for the taxpayers of New Jersey."