When Jack was diagnosed with autism three years ago, our pediatrician prescribed speech and occupational therapy. She also prescribed applied behavior analysis (ABA) therapy. I walked out of her office fully anticipating wait lists and lots of appointments.
What I didn't anticipate was the blatant discrimination we were destined to receive at the hands of our insurance company. I didn't realize that an autism diagnosis equated a coverage death sentence for those needing treatment.
I had no idea I would hear one word over and over and over:
Speech and OT were limited to a certain number of visits. (Seems as though one hour of speech therapy per month and two hours of occupational therapy per month were considered appropriate in the eyes of our insurers.)
Let me say that again. One hour of speech per month...for a nonverbal child.
If I hadn't lived it, I wouldn't believe it.
And as for the forty hours of ABA prescribed: Denied. Denied. Denied.
We turned to our affluent Texas school district hoping they might help. We hired a lawyer. Drafted letters. Attended meetings. And got absolutely nowhere...
Our child was sick. Our doctor prescribed evidence-based treatment. And it was completely up to us to pay for it.
I wish I could say our story was the exception as opposed to the rule. The sad reality is that in the vast majority of homes affected by ASD across our country, children are not receiving services. There are some savvy corporations that have stepped up and done the right thing by covering treatments. (Microsoft and Home Depot cover ABA.) There are also several states that have mandated coverage. (Texas, Louisiana, Arizona, Florida and Pennsylvania to name a few.)
Unfortunately, these band-aids aren't controlling the blood loss. The wound is gaping. Major surgery is warranted.
But today, maybe, just maybe, we have some reason to hope...
Per the Autism Votes web site:
(November 5, 2008) President-Elect Barack Obama's win last night may prove to be a win for the autism community as well. In his campaign statement on Autism Spectrum Disorders, Obama has committed to bringing autism insurance reform to our entire nation.
His statement reads, Obama and Biden "will mandate insurance coverage of autism treatment and will also continue to work with parents, physicians, providers, researchers, and schools to create opportunities and effective solutions for people with ASD."
You can read a draft of President Obama's federal mandate for autism insurance coverage HERE.
Here's to coverage for treatment, no matter what your zip code or your bank balance is. Here's to acknowledging the fact that autism is treatable and insurance should cover that treatment. Here's to doing the right thing.
Here's to hope.
To join me on this journey of hope, please register for legislative updates at Autism Votes.