June 03, 2009

Gillibrand Unveils 3-Point Plan to Make Quality Autism Treatment Affordable for Families

Study Shows Autism Affects More New York Children than Pediatric Cancer, Diabetes, AIDS Combined, But Insurance Companies Not Covering Necessary Treatments

Washington, D.C. - In response to new estimates that Autism Spectrum Disorders (ASD) affects approximately 29,401 New York children - more than pediatric cancer, diabetes and AIDS combined, U.S. Senator Kirsten Gillibrand is unveiling a three-point plan today to provide quality, affordable treatment to families who have children with ASD.  Even in the face of these rising numbers, insurance companies are refusing to provide adequate coverage, forcing middle class families to pay as much as $6,000 per month for treatment.

Senator Gillibrand's plan includes:

1)  A mandate on all private insurers to cover autism treatments;

2)  New legislation she is authoring called the Uniformed Services with Autism (USA) Heroes Act, to provide quality coverage for military families; and

3)  Increase federal investment in Autism research by dedicating a portion of the additional $10 billion given to the National Institute of Health (NIH) under the President's Economic Recovery plan.

"Thousands of New York families are being pushed toward bankruptcy because of the cost of providing autism treatment for their children," Senator Gillibrand said. "We know that early intervention is the best way to ensure a child's long term success. We've come a long way in developing effective treatments to help children living with autism lead healthier, more successful lives, but insurance companies are often refusing to pay for it. Families simply can't afford to spend thousands of dollars each month to give their child the care they need. My three-point plan will make quality care affordable for families with private insurance and military families, and will invest millions in new research that will benefit the lives of millions."

A new case of autism is diagnosed every 20 minutes - making it the fastest-growing serious developmental condition in America. If the pace of this disorder continues, autism could reach 4 million Americans in the next 10 years. Despite autism's far reach, insurance companies still deny families coverage for necessary treatments - costing them up to $6,000 out-of-pocket each month.

VIEW Senator Gillibrand's autism report.

Across New York, it is estimated that nearly 30,000 children suffer from autism:

  • Of the 1,912,617 children in New York City, an estimated 12,757 live with autism;
  • Of the 305,371 children in Western New York, an estimated 2,036 live with autism;
  • Of the 251,214 children in the Rochester-Finger Lakes region, an estimated 1,805 live with autism;
  • Of the 232,865 children in Central New York, an estimated 1,554 live with autism;
  • Of the 124,903 children in the Southern Tier, an estimated 834 live with autism;
  • Of the 238,598 children in the Capital Region, an estimated 1,591 live with autism;
  • Of the 101,577 children in the North Country, an estimated 677 live with autism;
  • Of the 448,926 children in the Hudson Valley, an estimated 3,662 live with autism; and
  • Of the 672,595 children on Long Island, an estimated 4,486 live with autism.

To help improve the lives of children and families living with ASD, Senator Gillibrand has developed a three-point plan:

1. Mandate Insurance Companies to Cover Autism
It's time for insurance companies to stop denying coverage to families living with ASD. It's a cost they just can't afford, and a drain on the entire economy. That's why Senator Gillibrand is joining her colleague Senator Dick Durbin to co-sponsor the Autism Treatment Acceleration Act to stand up to big insurance companies and mandate they cover ASD.  The bill would require all private insurers nationwide to cover evidence-based, medically-necessary autism treatments and therapies - including Applied Behavior Analysis (ABA) therapy.

ABA is a scientifically validated treatment program for ASD, recommended by the American Academy of Pediatrics and the National Academy of Sciences. ABA therapy is proven effective, but only at the recommended levels of 25-40 hours a week - a level that can cost families up to $6,000 each week, which many families just can't afford in these tough economic times, or any time. The Autism Treatment Acceleration Act would make sure families can get the treatment their children need through coverage they can afford.

2. Author New Legislation to Cover Autism for Military Families
TRICARE - the military health insurance program - currently considers ABA therapy special education and not medically necessary treatment, and caps coverage for ABA at $3,000 a month. That amounts to only 16 hours of therapy a month - a fraction of what's necessary to actually improve the life of a child suffering from autism. As a result, military families are forced to choose between paying out-of-pocket to get the therapy their children need, or forgoing therapy altogether. What is worse, thousands of military families are forced to the bottom of long waiting lists for a specialist each time they are relocated.

To combat these problems and help take the strain of military families living with autism, Senator Gillibrand is authoring and introducing the USA Heroes Act to require TRICARE to cover autism treatment, including ABA therapy to help military families get the care their children need.

3. Increase Federal Investments for Autism Research
Cutting-edge research holds the potential to help children suffering with autism live better, healthier lives, and one day lead to a cure. That's why Senator Gillibrand is calling for a portion of the $10 billion that was allocated under the Economic Recovery plan for the NIH, be dedicated to research ASD. With better funded research, scientists and laboratories will have the resources they need to reach breakthroughs to improve care - helping children with autism get the care they need in early stages and help them live long, healthy, successful lives.

Senator Gillibrand's three-point plan to address autism is part of her broad agenda to improve the lives of children and families across New York. As a mother and a lawmaker, Senator Gillibrand is a strong voice for New York families. One of her first acts as Senator helped President Obama reauthorize the Children's Health Insurance Program - providing health care for 11 million low and middle-income children across America.

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