December 19, 2012

Gillibrand Announces her Amendment to Cover Care for Military, Other Uniformed Services Kids with Autism Included un Final Agreement Between Senate-House Defense Bills – Will Head to President’s Desk as Part of 2013 Defense Bill to be Signed Into Law

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

Washington, DC – U.S. Senator Kirsten Gillibrand, a member of the Senate Armed Services Committee, today announced the Senate-House conference committee report of the National Defense Authorization Act for 2013 includes Gillibrand’s amendment that would cover behavioral treatment for uniformed services children with autism spectrum disorders. Based on the USA Heroes Act that Senator Gillibrand authored and introduced in 2009, this bipartisan amendment under the 2013 National Defense Authorization Act (NDAA) bill would help reduce the burden of uniformed services families and their children living with autism by requiring the military health insurance program to lift restrictions on behavioral care and expand proven treatment. Now that Gillibrand’s amendment has cleared the bipartisan conference committee, it is expected to pass both houses of Congress this week and will head to the President’s desk for his signature.

“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 legislation 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, Coast Guard, National Oceanic and Atmospheric Administration (NOAA) and Public Health Service 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 these families have the care they need, Senator Gillibrand’s amendment would require TRICARE to meet the minimum threshold of basic care, covering behavioral treatment for autism, 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 was co-sponsored by Senators Joe Lieberman (I-CT), Scott Brown (R-MA), John Kerry (D-MA), Richard Blumenthal (D-CT), Mark Begich (D-AK), Bob Menendez (D-NJ). Bernard Sanders (I-VT), Daniel Akaka (D-HI), Barbara Mikulski (D-MD), Patrick Leahy (D-VT), Sherrod Brown (D-OH), Saxby Chambliss (R-GA), and Marco Rubio (R-FL).