Councilmembers Tommy Wells Announces Insurance Reform for Children with Autism

On Monday, November 16th, Councilmember Tommy Wells joined Councilmember Muriel Bowser, families of children with autism, and autism care advocates to announce that they will introduce legislation to reform health insurance for children with autism in the District.

Titled the “Health Insurance Coverage for Children with Autism Act of 2009,” the bill will create better access to care, better access to treatments and therapies, and create new requirements for insurance companies to provide expanded benefits up to $55,000 per year.

Councilmember Wells stated, “This legislation will dramatically expand health insurance benefits for children with autism. It’s the right thing for our families and our children.” He added, “Expanding access to early diagnosis and therapies can make all the difference in the life of a child with autism.”

Councilmembers Wells and Bowser were joined by DC families with children with autism, as well as local and national autism care advocates.

“The introduction of the autism insurance reform bill in the DC Council is another significant step forward in the national effort to secure autism insurance coverage across the country and provide families with the help they so desperately need and deserve,” said Stuart Spielman, Autism Speaks Senior Policy Advisor and Counsel. “We thank Councilmember Wells and Councilmember Bowser for having the courage to put families and their needs first.”

The new law will help families diagnose and find treatment and therapies for autism spectrum disorders. In many cases, insurance plans cover some, but not all, of the therapies needed to help children develop, maintain or restore a variety of functions. The lack of coverage forces families to spend tens of thousands of dollars each year for the care their child needs, and often leaves low and middle income families the unacceptable choice of simply going without care.

The CDC estimates 1 in 150 children are born with autism in the United States. Autism is a complex neurobiological disorder that typically lasts throughout a person's lifetime. It is part of a group of disorders known as autism spectrum disorders (ASD). It occurs in all racial, ethnic, and social groups and is four times more likely to strike boys than girls.

Early therapeutic treatment, such as Applied Behavior Analysis (ABA), Relationship Development Intervention (RDI), and Developmental, Individual Difference, Relationship-based (DIR) care, have been shown to make a significant impact on reducing symptoms and improving the quality of life and educational opportunities. Many insurance plans however do not provide for appropriate therapeutic treatment, leaving families with extreme out of pocket costs or forced to forgo treatment options altogether. Costs can be as high as $55,000 per year for autistic treatments and therapies.

To date, 15 states have passed autism reform insurance requirements.

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