New autism law requires coverage for some - KWWL - Eastern Iowa Breaking News, Weather, Closings

New autism law requires coverage for some


DUBUQUE (KWWL) -- One in every 110 children suffer from autism. It costs parents up to $40,000 a year to treat, most of that comes out of pocket because insurance companies don't cover treatments. A new Iowa law is providing coverage for a small group of people.

Starting January 1, eight states, including Iowa, expanded insurance coverage for kids with autism. The state health insurance plan must now provide coverage for diagnosing and treating autism in children of state employees. But what about families that have private insurance? And for those who don't work for the state? They say this new law could set the bar for the future.

Inside Dubuque's Mercy Autism Treatment Center, a therapy room sits empty, but only for awhile.

"We do speech therapy, occupational therapy, behavioral therapy and pretty soon we'll be starting eating groups to work on selective eaters. And we do social interaction and social skill groups for all ages," said behavioral specialist Alyson Beytien.

Beytien sees dozens of children with various levels of autism. Their families however, face the same obstacles.

"Some insurance companies will cover speech therapy and occupational therapy. Some to a small extent," Beytien said.

But they don't cover all treatments, including behavior therapy.

"We call it applied behavioral analysis. Which research has shown is the one intervention that will help the most. That will allow the child to make the most progress. And it can run about $35,000 a child per year to do that," Beytien said.

A new state law expands health insurance coverage to children with autism. But only if their parent is a state employee who has state sponsored health insurance. Beytien is a mother of three autistic children, she says although the law doesn't include everyone, it's a step in the right direction.

"It's a very small step but at least it will start to have those discussions more," Beytien said.

She says Iowa runs into a big problem: there is not exact data about how many kids have autism. In Dubuque, for example, there is an estimated 160 students receiving services for autism like symptoms.

"We don't have that many kids. But those that we have, what a critical need. And these are our children we're talking about so we want to be able to help. And we can we can make a huge difference," Beytien said.

One of the reasons autism treatments aren't covered on most private insurance companies: it's not currently listed as a disease. Beytien says that will change soon. Still, treatments aren't predictable, one child may only need a year, another several years.

The Iowa law was passed during last year's session after a broader mandate was struck down. The new expansion provides up to $36,000 a year in care for autism. And expands the definition of treatments. The new law is expected to cost an extra $132,000.

Some law makers are still pushing for a broader mandate that would require companies with 50-plus workers with state regulated insurance to cover autism treatments.

Minnesota and Illinois have similar laws to Iowa's. Wisconsin is known for it's coverage. It starts at birth until age ten, and provides up to $36,000 a year. Four years intensive coverage is required. Following that, it's reviewed every year, with a cap of $25,000 after the age of ten, as long as treatment is still needed.

Wisconsin currently has a two year waiting list for those wishing to receive coverage.

Online Reporter: Lauren Squires

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