RICHMOND, — Legislation introduced by Del. Robert Thomas, R-Stafford, would expand autism insurance coverage to nearly 10,000 Virginians and lift the cap that excludes those over the age of 10.
Under current law, individuals with autism can get insurance only from ages 2 through 10. Autism is the only medical condition that has an age-based coverage limit, Thomas said. His bill, HB 2577, would eliminate the restriction.
“No other health impairment including asthma, diabetes or cancer has such age limits imposed on them,” Thomas said Tuesday at a press conference about the bill. “And we believe that coverage for all of these health conditions is based on medical necessity, and autism should be treated no differently.”
House Speaker Kirk Cox joined Thomas at the event and expressed his support for the bill.
“This announcement has been a long time coming in Virginia,” Cox said. He noted that according to estimates from the U.S. Centers for Disease Control and Prevention, “autism impacts 1 in 59 children in our country. This number is growing 15 percent a year.”
A 2013 report from the Autism Center of Excellence at Virginia Commonwealth University said that on average, children are diagnosed as having autism at 6 or 7 years old. As a result, those families have only about four years of access to affordable insurance.
After a child with autism turns 11, individuals can access affordable care only if they receive a “Developmentally Disabled Waiver” from the state. But there aren’t enough waivers to meet the demand, parents say.
The “Fighting Fletchers,” a Midlothian family with three autistic sons, joined advocates from the Virginia Autism Project at the press conference. Kate Fletcher, the boys’ mother, said the Developmentally Disabled Waiver waitlist of nearly 13,000 has left her family feeling abandoned by the state.
“All three of my boys are on that waitlist. Matthew’s been in the most urgent category for seven years now,” Fletcher said. “If we can’t access waiver supports, and we can’t access insurance past the age of 10, the state has effectively shut doors in our face the whole way.”
Individuals with autism who can get the insurance receive pharmaceutical, psychological and therapeutic care.
“Our children did not choose to be born with autism, and we feel that we should do everything we can to continue to learn about the causes of autism, but more importantly, to provide the treatment that we know is having a meaningful effect for these children regardless of their age,” Thomas said.
State officials estimate that it would cost about $237,000 a year to extend autism insurance coverage to nearly 10,000 more people. But advocates said the future benefits far outweigh the costs.
By having insurance and receiving treatment, a person with autism will require less in social services later on. The insurance “will save the state $1-2 million per person covered over their lifetime,” Fletcher said.