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Even with insurance raising an autistic child is expensive.



Published: Thu, January 31, 2013 @ 12:00 a.m.

By William K. Alcorn

alcorn@vindy.com

YOUNGSTOWN

The heads of local autism programs praised Gov. John Kasich’s directive as an important step forward.

The directive requires autism-insurance coverage effective in 2014 as part of Ohio’s minimum-coverage rules needed for compliance with the federal Patient Protection and Affordable Care Act, known as Obamacare.

“We couldn’t be happier that this happened,” said Georgia Backus, director of the Rich Center for Autism, which operates under the auspices of Youngstown State University.

“Regardless of how much money you make, even with insurance, it’s very expensive to raise an autistic child,” Backus said.

Speech and occupational therapy are covered by insurance, but not if they come under an autism diagnosis, she said.

“Once parents get that diagnosis, they ask, ‘Where do I go for help?’” Backus said.

What the governor’s mandate means to parents of autistic children is that it gives them a fighting chance to get health-insurance coverage, when before, no matter what, it was going to be denied. This legislation will ease a little bit of this burden, she said.

“Our state is just getting started, but we are so fortunate we are now on that path. It’s wonderful news. This is the result of many years of effort,” Backus said.

“At the end of the day, to deny a human the support of health-insurance coverage simply because of an autism diagnosis is unacceptable. Gov. Kasich is to be commended. It was a wonderful, humanitarian thing he has done on behalf of kids,” she said.

The inclusion of autism services as part of the Essential Health Benefit (EHB) package of the Patient Protection and Affordable Care Act is a huge victory for children, families and the autism community in general, said Paul Garchar Jr., executive director of the Potential Development Program in Youngstown, which offers autism services.

This is especially true for parents who have just found out their child has autism. Once they get the diagnosis, parents need to begin looking for services for their child. They do not need to be worried about fighting with an insurance company about what is or is not covered, Garchar said.

Applied Behavioral Analysis (ABA), speech, occupational and behavioral health services are important components to any child’s treatment plan. Research has proven repeatedly that guaranteeing access to service as early as possible will provide long-term benefits to the child, he said.

“On behalf of Ohio’s children with autism and their families, the Ohio General Assembly and Gov. Kasich should be commended for moving this piece of legislation forward. Prior to this, Ohio was one of only 18 states who had not yet addressed this issue,” Garchar said.

“I do think we are moving in the right direction, but we haven’t sorted out the implications of what this means for all families,” said Dr. Leah Gongola, a behavioral analyst with a practice in Huntsburg. “It hasn’t really been defined who will be covered and what the coverage will be.

“It sounds like the directive will take effect beginning in 2014. Hopefully, everyone will work together to define what this will mean for each family by then,” Dr. Gongola added.


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