“When I started down this advocacy path a dozen years ago, the only families who could access ABA for their children with autism were wealthy families and those lucky enough to live in the few states (that funded therapy programs),” “Now, most families in the United States have coverage for ABA.”
-- Lorri Unumb, CEO of the Council of Autism Service Providers
Autism Spectrum Disorder/ASD impacts a person's developmental and neurological growth from the minute they are born. This disorder impacts many different aspects of a person's life. For instance; interactions with others are often harder and marked learning, and behavioral delays in development can be seen.
In order to officially diagnose autism, doctors or healthcare providers will observe the patient's behavior/development as well as administer screening instruments. These instruments are designed to measure where the patient falls on the spectrum these evaluations are usually done during childhood but can also be conducted for adults as well.
The National Institute of Mental Health states that examinations are usually comprised of.....
Medical and neurological examinations
Assessment of the child’s cognitive abilities
Assessment of the child’s language abilities
Observation of the child’s behavior
An in-depth conversation with the child’s caregivers about the child’s behavior and development
Assessment of age-appropriate skills needed to complete daily activities independently, such as eating, dressing, and toileting"
While there is no cure for Autism Spectrum Disorder (ASD), there are many treatment options. These options include medications, and various types of interventions that take specific approaches for example; behavioral, psychological, educational, or developmental. Medication is used only to treat symptoms experienced with ASD, not the condition itself. This website provides a detailed breakdown of the types of treatment available as well as a brief description of how they work.
Researchers in Australia conducted a study in 2014 looking into "The Cost of Autism Spectrum Disorders" and discovered that annually the median cost was around $34,900 AUD roughly $24,200 USD and the cost only increased the more on the spectrum the family member was.
Sadly in the USA, it is worse and treatment by route of Applied Behavioral Therapy (ABA) is estimated to cost over $60,000 dollars a year. Below are some cost breakdowns copied from Autism Parenting Magazine:
10 hours per week x $120 = $1,200 per week or $62,400 per year
20 hours per week x $120 = $2,400 per week or $124,800 per year
40 hours per week x $120 = $4,800 per week or $249,600 per year
Keep in mind these treatments are vital for the patient to be able to thrive in his or her life. These exorbitant costs added to the already increased financial burden of caring for someone with ASD put a severe strain on caretakers.
Insurance is a very confusing system/topic, this 2 part video series explains it a lot better than I can!
The NCSL concludes that the main oppositions to coverage are-
Arguing that care for individuals with autism is the responsibility of parents and the school systems
Individual states who lean more right tend to have more stringent coverage whereas states that are more left-leaning tend to have broader coverage
Kickback due to worry that insurance premiums will increase
ASD is a costly disorder and that tends to lead insurance companies to do everything they can to provide the bare minimum
People view those impacted by ASD as a lost cause that cannot be helped
Most neurological disorders/conditions are still viewed as "less important" and due to that many customers are not offered the most effective treatment due to outdated ideas/information
After mandates were passed requiring insurance companies to give coverage to those with ASD all 50 states are now compliant though each state offers varying levels of coverage. The research concluded that the level of coverage depended on the state's party association.
This website allows you to look at each states statute regarding ASD coverage- https://www.ncsl.org/research/health/autism-and-insurance-coverage-state-laws.aspx
Find a way to convince these huge insurance companies to be less profit-hungry and focus instead on the level of care and resources they can provide to their customers
Push to pass laws that require insurance companies to do extensive research (in ASD) and have a realistic idea of the amount of money needed to provide acceptable treatment options as well as be better versed in the needs and requirements disorders come with
Acknowledge that ASD isn't a static disorder, with correct treatment options and care patients can achieve better outcomes in life
Fix an outdated mindset