Senator Fuschillo: Families Need Immediate Action on Autism Insurance Reform

Charles J. Fuschillo Jr.

September 30, 2009

Calls on Leadership in Senate and Assembly to Bring Fuschillo/Weisenberg Legislation to a Vote 

With parents being forced to spend tens of thousands of dollars out of pocket to get care for their children to autism, New York State Senator Charles J. Fuschillo, Jr. renewed his call to the leadership in the State Senate and Assembly to allow a vote on his legislation to get these treatment costs covered by insurance. The legislation enjoys widespread support in both houses, with 52 Senators and 50 Assemblymembers serving as cosponsors.

Senator Fuschillo’s reemphasis comes days before Autism Speaks’ annual “Walk Now for Autism” event at Jones Beach, where over 20,000 people walk on behalf of loved ones with autism to raise funds for research and increase awareness about autism.  

 “Parents who have children with autism desperately need this reform. This bill is cosponsored by nearly every Senator in the New York State Senate. The next time the Legislature is called back into special session, there is no reason not to bring this legislation to a vote and get these families the help they need.” said Senator Fuschillo (R-Merrick).

Children with autism throughout New York State are routinely denied insurance benefits for treatment of their disorder, forcing their parents to pay for these therapy costs out of pocket. Therapy costs for children with autism typically run between $20,000 - $50,000 per year.

Under the legislation (S2366) being sponsored by Senator Fuschillo and Assemblyman Harvey Weisenberg (D-Long Beach), private insurance companies would be required to offer treatment coverage for children with autism ages 21 and under. Treatments that would be covered under the proposed law include medications, speech therapy, occupational therapy, physical therapy, applied behavioral analysis, counseling, psychiatric and psychological care and any other care determined by the State Department of Health to be medically necessary.

The maximum coverage benefit would be $36,000 through December 31, 2010, after which the benefit would be adjusted annually for inflation by the New York State Superintendent of Insurance. There would be no limits on the number of visits an individual may make to an autism provider (up to the $36,000 limit). Payments made by an insurer for treatment or care unrelated to autism spectrum disorders would not be applied towards the maximum benefit.  

New Jersey recently enacted a law requiring insurance companies to provide coverage for evidence based, medically necessary autism therapies. Fourteen other states, including Connecticut and Pennsylvania, have passed similar laws.

Autism is a complex neurobiological disorder that typically lasts throughout a person’s lifetime. It is the fastest growing developmental disability in the United States, and is more common than pediatric cancer, AIDS, and diabetes combined. It is part of a group of disorders known as autism spectrum disorders (ASD). According to the Center for Disease Control, 1 in 150 children are diagnosed with ASD. It occurs in all racial, ethnic, and social groups and is four times more likely to strike boys than girls. Autism impairs a person’s ability to communicate and relate to others. Symptoms can range from very mild to quite severe.