We've had a minor break though in Michigan regarding health insurance and covering the various expensive therapies for autism. Up until Monday, most health insurance companies in our state declined to pay for therapies such as Applied Behavioral Analysis (ABA) or Play Therapy.
Finally, according to this Detroit News article, Blue Cross Blue Shield is going to start paying for ABA for children between the ages of 2-5. This is great news for parents of young children as early intervention is found to be beneficial for most individuals. This is not so great news for everyone else who has children with autism older than the age of five.
As you will see if you click on the link above, the insurance company is under the threat of being sued. A seven-year-old autistic child's dad, Christopher Johns, filed suit in federal court in May 2008. According to the article he filed the law suit on behalf of "the more than 7,000 children" in Michigan who have autism.
One of the reasons insurance companies have declined to pay is because "long-term studies on autism educational therapies have been inconclusive and the treatments are experimental." Another reason is that although my state lawmakers are working on it, Michigan is not yet amongst the ten or eleven states in the U.S. where state law mandates coverage for therapies that parents seek out for their children with autism spectrum disorder.
I find it ironic that autism is classified as a health issue in the United States, yet it seems to be the school systems that help people the most. Unfortunately, even schools are limited in the amount of services they can provide due to budget restraints. Often, the special education division does not start the Individualized Educational Plan (IEP) process until a diagnosis is issued from a physician.
This is a concern because physicians, especially general family practitioners, are still learning how to spot the symptoms of ASD. Sometimes, as in the case with my child, autism isn't diagnosed until the age of six. This may mean a missed opportunity for early intervention, and, now, coverage from insurance companies.
So you see, it may be awhile before people with ASD in Michigan have access to the (often very expensive) services that may help them. There could be years of fighting before things start to improve. I will be watching the lawsuit while also monitoring the progress of state lawmakers in Michigan while they contemplate passing legislation that will be helpful to this cause. I'm not holding my breath just yet...