ACT Now! Autism Insurance Reform Makes Sense… and Benefits Everyone

Written by Ann Telfer

In 2007, a landmark study published by the Harvard School of Health stated that the lifetime cost of caring for an individual with autism spectrum disorder (ASD) is estimated to be $3.2 million (Ganz, 2007). Imagine the response of a couple, upon hearing this number, when they have just received a diagnosis of ASD for their preschool age child. At the very next juncture, these parents also learn that in order to have a potentially positive outcome for their own son or daughter with autism, they will need to find an intensive, early intervention program, for at least 25 hours a week, over 12 months (Lord & McGee, 2001). What is perceived as public awareness and education is in fact, an individual family’s nightmare. The trauma and stress associated with receiving a diagnosis of ASD is compounded by the costs associated with doing the “right thing”. And that “right thing” is finding resources to pay for an intensive intervention program, until the child enters grade school and sometimes beyond.

It wasn’t long ago that the medical community believed that autism was untreatable. Today, research has shown differently, especially if the treatment is early, and intensive.  If autism is not treated, in many cases, the child will require full time care over their lifetime. The cost of “non treatment” will be incurred by families, Michigan-based companies, and the State of Michigan (disabled children usually get lifetime medical insurance).  In Michigan, this amounts to $53 billion, accounting for the 14,000 children currently in the system.

ASD is a complex developmental disorder that impacts a person’s ability to communicate and interact with others, and is usually diagnosed by the age of two or three. Autism is the result of a neurological disorder that affects the functioning of the brain, indicating difficulties in verbal and non-verbal forms of communication, especially in language, social interactions and play/leisure activities. Although current prevalence rates vary depending on the source, the Center for Disease Control and Prevention estimates that one in 110 births is affected (CDC, 2006).  

Health insurance plans have systematically excluded treatment for individuals with ASD in Michigan.  The premium increase cost to policy-holder is estimated to be 1% or even less (in New Jersey, the premium increase was 0.79%).  

In consideration of Michigan’s much needed economic reform, health insurance coverage could save our public schools about $200,000 per child over the course of their time in school, representing a total savings of about $1.5 billion.  In contrast, families who currently want what is best (and medically proven) for their child, should expect to pay up to $50,000 a year.  In addition to the intense financial burden, the time, energy and stress of parenting children with autism can impact employment, health and marriage.  For companies that  have an employee with a child with autism, chances are these individuals are working reduced hours, getting a divorce or have stress related medical expenses.  

Act now!  Autism reform legislation passed the Michigan House in the spring of last year, and now needs to move on to the Senate.  Call Senate Majority Leader Michael D. Bishop (517-373-2417) and tell him how this coverage would help your family and would be the fiscally responsible things to do for the state of Michigan!

References

Autism Society of America: http://www.autism-society.org/

Autism Votes : www.autismvotes.org/michigan

Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report, December, 2009 / 58(SS10);1-20.  http://www.cdc.gov/mmwr

Ganz, ML. (2007). The lifetime distribution of the incremental societal costs of autism.  Archives of Pediatrics and Adolescent Medicine, 161, 343-349.

Konstantareas, MM., Homatidis, S.,&  Plowright, CMS. (1992). Assessing resources and stress in parents of severely dysfunctional children through the Clarke modification of Holroyd’s questionnaire on resources and stress. Journal of Autism and Developmental Disorders. 22,217-34.

Lord, C. & McGee, J.P. (Eds.) (2001). Educating children with autism. Washington, DC: National Academy Press.