Bill seeks equal access to medical treatment for autism

(State House) – On Tuesday, May 21, the Joint Committee on Children, Families and Persons with Disabilities conducted a public hearing on a bill filed by Rep. Garrett J. Bradley, D-Hingham, which would require MassHealth to cover the cost of habilitative or rehabilitive medically necessary treatment for individuals under the age of 21 who are diagnosed on the autism Spectrum.

Rep. Bradley said, “The goal of this legislation is to ensure that the 2010 law mandating coverage for autism spectrum disorders includes MassHealth, as well as state-regulated private health insurance plans.  There are approximately 6,000 low-income children with autism who are enrolled in MassHealth, however only 157 recipients are currently covered under the autism waiver program.”

The passage in 2010 of ARICA, which requires private insurance to cover treatments for autism, applies only to state-regulated health insurance plans.  Examples of treatments include, but are not limited to, Applied Behavior Analysis.  The Department of Public Health’s Early Intervention program provides access to services and treatment for children, but only up to age three, paying all costs that are not covered by insurance and for eligible children who have no insurance.  And while some large employers have self-funded insurance plans that voluntarily include coverage, many still do not, making it difficult for some to obtain medically necessary services that could be paid for through their insurance company.  This bill would also cover the cost for both dedicated and non-dedicated augmentative and alternative communication devices.

The legislation, H.76, was filed after the Governor’s Special Commission Relative to Autism issued several recommendations for further action by the Legislature.  Representative Bradley served as a member of the Autism Commission.