Requiring many health insurance plans to cover autism services will provide relief to families trying to make sure their children get the treatment they need, the head of a local autism group said.
Ohio Gov. John Kasich last week announced policy changes that would require state employee health insurance, private insurers and coverage purchased through the coming federally mandated health care exchange to pay for assessments, treatment plans, speech and occupational therapy and treatment aimed at improving communication and social skills for children with autism.
"If you have to pay out of your pocket for the speech therapy and language and the OT, you can get up into a couple thousand dollars a month," said Mark Weihl, president of the board of directors for the Autism Center of Southeastern Ohio. "The financial impact can escalate pretty quickly."
Weihl's 9-year-old son, Jack, was diagnosed with autism and now attends Putnam Elementary School, something he said would not have been possible without early diagnosis and therapy to strengthen his ability to interact with other children and perform age-appropriate activities.
The change is something Marietta resident Karen Smith, treasurer for the board, believes should have happened a long time ago. Her son, Nicholas, could not speak at age 4, but it wasn't until the family received a waiver from the Ohio Department of Developmental Disabilities that the boy had access to the full range of care he needed.
"He could not get any therapies at all with our insurance," Smith said. "He got the therapy he needs, and now he's talking."
Autism affects verbal and non-verbal communication and social interactions, generally evident before age 3, in a way that adversely affects a child's educational performance.
One in 88 children is diagnosed with autism.
Thirty-two states besides Ohio currently guarantee the provision of autism services in health insurance.
Source: Ohio governor's office.
Ohio already covered autism services for Medicaid recipients. While the new policy affects state employees and a number of individuals on private plans, it does not include entities that are self-insured or large group insurers.
Ginger O'Connor, director of early childhood and therapy at Ewing School, said she was "thrilled" to hear about the policy change but feels there's still work to be done.
"It's really a good step in the right direction," she said. "Now we need to carefully look at the insurance policies that are not (included)."
More needs to be done to make sure autism services are not so expensive that all plans don't cover them, O'Connor said.
The expense of including autism services for small businesses is one reason the Ohio Chamber of Commerce expressed reservations about Kasich's move.
"Their options for controlling these costs are limited, and today's decision jeopardizes the health benefits many families count on," Keith Lake, a lobbyist for the chamber, told the Associated Press.
In a news release, the governor's office said "Ohio's coverage levels will balance the call for a robust, meaningful benefit package with the reality of job-creators' economic and financial pressures and their need to keep premium costs low."
The release also notes there is an expectation that a federal review of states' health insurance coverage in 2016 could result in revisions for states without minimum coverage levels for autism and other habilitative services.
The Associated Press contributed.