Another call to action for autism insurance coverage in Oregon from Paul Terdal:
• Update on SB365 – Insurers want a subsidy; threaten to sue Oregon if it enforces existing law
• ACTION #1: Call Governor Kitzhaber
• ACTION #2: Send an E-mail to Governor Kitzhaber
• ACTION #3: Send an E-mail the Ways and Means committee
Kaiser is first insurance company in Oregon to cover ABA treatment for children with autism. There is no age noted for coverage consideration in the link below. There is some reports that Kaiser might be requiring parents to be present during ABA therapy and involved 80% of the time, which makes it very difficult, if not impossible, for many working parents.
The "Achieving Better Life Experience Act," or ABLE Act is a bill would allow people with disabilities the ability to create special savings accounts where they could accrue as much as $100,000 without losing access to benefits like Social Security or Medicaid. The bill amends the Internal Revenue Code to establish tax-exempt ABLE accounts to assist an individual with a disability in building an account to pay for qualified disability expenses.
Senate Bill 1568 came before public testimony on Friday, February 10th. Testifying on behalf of the bill (which would cover Applied Behavior Analysis amongst other treatments) were Dr. Robin McCooy, Melanie Shaw, Tobi Rates, and Paul Terdal. The insurance industry thinks they might come to an agreement by 2013.
I've been watching autism legislation bills come and go for years. This is the first time I have heard of an insurance company (northwest nonprofit) recommend making the bill better for people with autism. According to an email from Paul Terdal, "PacificSource insurance announced that they 'had been on the wrong side of this issue in the past' and proposed an alternate amendment that refined some of the details of the language, and raised the age limit on ABA from age 11 to age 18.
On September 28th, a federal court judge in Portland ruled in favor of the McHenry family in their suit against PacificSource, ordering the insurance company to cover the cost of ABA treatment for their 6-year old son with autism. The ruling was based in large part on Oregon's existing Mental Health Parity law, and included many critical decisions:
* ABA therapy is not experimental or investigational in nature and PacificSource lacked a reasonable basis for reaching the opposite conclusion