November 28, 2012

As Senate Begins Debate on 2013 Defense Bill, Gillibrand Introduces Bipartisan Amendment to Cover Autism Care for Military Families

Gillibrand Amendment Lifts Restrictions on Treatment for Tens of Thousands of Military Children Suffering from Autism

Washington, DC – As the U.S. Senate begins debate today on the 2013 National Defense Authorization Act (NDAA), U.S. Senator Kirsten Gillibrand introduced a bipartisan amendment that would cover behavioral treatment for military children with autism spectrum disorders. Based on the USA Heroes Act that Senator Gillibrand authored and introduced in 2009, this amendment would help reduce the burden of military families and their children living with autism by requiring the military health insurance program to lift restrictions on autism care and expand proven treatment by meeting the national recommended standards.

“It is alarming that our military families who have sacrificed so much are denied essential services for their children suffering from autism,” said Senator Gillibrand. “This amendment will help ensure that our military families have access to the critical services, care and support they desperately need and deserve.”

Autism is the fastest growing developmental disability in the country, with over 23,000 TRICARE beneficiaries diagnosed with autism. Nationwide, this disease affects 1 in 88 children and 1 in 54 boys, according to the Centers for Disease Control.

The current military health insurance program (TRICARE) does not cover applied behavior analysis (ABA), a treatment recommended for autistic disorders, leaving retirees and reservists and their families without care. Under the Extended Care Health Option (ECHO), available only to active duty personnel, ABA therapy is covered, but capped at $36,000 a year or an estimated 6 to 11 hours of therapy a week – a fraction of the care medically recommended to improve the life of a child suffering from autism.

As a result, tens of thousands of military families impacted by this disease suffer emotional and financial strain and are forced to choose between paying out-of-pocket or forgoing therapy altogether. Forced to rely solely on other coverage, families find themselves at the end of a long line waiting list for a specialist each time they relocate.

To ensure that military families have the care they need, Senator Gillibrand’s amendment would require TRICARE to meet the minimum threshold of basic care, cover autism treatment modeled after national standards, and lift the financial cap on care. More than 30 states already have laws in place that require private insurers to cover ABA as a medically necessary health service and starting next year, federal civilian employees may see ABA-inclusive health benefits.

The amendment is co-sponsored by Senators Joe Lieberman (I-CT), Scott Brown (R-MA), John Kerry (D-MA), Richard Blumenthal (D-CT), Mark Begich (D-AL), and Bob Menendez (D-NJ).