According to the Centers for Disease Control and Prevention ([CDC], 2013), “Autism spectrum disorders (ASDs) are a group of developmental disabilities that can cause significant social, communication and behavioral challenges.” The CDC estimates that 1 out of 88 children in the USA are diagnosed with ASD (Facts about ACDs). Some of these children can catch up with their peers if they are given appropriate treatment at an early age. For those whose disability is more severe, an early intervention still makes a big difference. Erin Raber shares her experience, “We’ve done stats [behavioral therapy for autism] and we’ve found out that if you spend one dollar now in early intervention, you save seven dollars later, in institutionalization, continuing special ed services, and everything else...”
However, it is easy to advise parents on early intervention, but the problem is that health care for children with ACD costs an enormous amount of money. Heasley (2014) confirmed the annual cost of health care per child diagnosed with ASD is $ 17, 081. Of course, early intervention services can be obtained when IDEA eligibility criteria is met, yet parents eventually end up paying a “hefty sum of money” out of their pocket. A study by Shimabukuro, Grosse , and Rice (2008) showed that the annual medical cost for a family with a child on the spectrum is $4,110 to $6,200 higher than for a family with a child who is not on the spectrum. Additionally, Medicaid-enrolled children’s cost for families with children on the spectrum reaches $10,709 per child, and it does not include intensive behavior intervention. The annual cost of behavior intervention ranges from $40, 000 to 60, 000 per child and very often families have to pay its cost out of their pockets. Thus, half of the families with children on the spectrum report that their existing insurance coverage fails to cover these costs. Some families due to the high cost of treatment are at risk of falling below the level of poverty, and some families are forced to postpone the therapy for their children.
According to Autism Speaks (2014), the Affordable Care Act, the federal law that is known as “Obamacare” and signed on March 23, 2010, brought quite a few changes in the American legislation that might help address some of the insurance coverage issues experienced by the autism community (The Affordable Care Act and Autism).
The first change is that insurance companies cannot any longer disallow coverage for pre-existing conditions. Autism is a pre-existing condition. Before the Affordable Care Act, most insurers denied coverage for people with Autism, or charged a higher premium, or excluded benefits for pre-existing conditions. In 2008, over 20,000 children were denied and 18,000 were restricted in coverage because of the pre-existing conditions (The Affordable Care Act and Autism, Pre-existing Conditions).
The second change is that insurance companies have to offer at least ten...