Press Release

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

Jun 3, 2009

D.C. –
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

Gillibrand’s plan includes:

 A mandate on all private insurers to
cover autism treatments;

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

 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.

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.”

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

  • Of
    the 1,912,617 children in New York
    City, an estimated 12,757 live with
  • 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
  • Of
    the 124,903 children in the Southern
    Tier, an estimated 834 live with
  • Of
    the 238,598 children in the Capital
    Region, an estimated 1,591 live with
  • Of
    the 101,577 children in the North
    Country, an estimated 677 live with
  • 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
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.