Treating autism in Georgia

Health plans should cover autism

By John Albers

Before the 2013 Legislative Session, I spent considerable time listening to the needs and concerns of my constituents. I was particularly struck by the number of families whose children have autism and the rising cost of their health care. I have a heart for those with specials needs and proudly sit on the board of directors for EnAble of Georgia. For these reasons, I decided to sponsor Senate Bill 191, known as Ava’s Law.

Ava Bullard was diagnosed with autism at age two and denied coverage under the state employee health plan. Her parents spent $5,000 a month for Ava to receive Applied Behavior Analysis (ABA) therapy, which is endorsed by the U.S. Surgeon General and the American Academy of Pediatrics as the treatment of choice for autism. Today, Ava is a fourth-grader in a general education classroom and no longer requires intensive treatment.

Autism treatment isn’t a mandated coverage under the Affordable Care Act, and only 26 states chose a benchmark plan that includes autism treatment under ACA. Georgia isn’t one of them, but last week, Gov. Deal recommended including autism treatment in the state employee healthcare plan. I applaud his decision and hope his leadership inspires my colleagues in the legislature to pass Ava’s Law.

Once Georgia health plans are required to cover meaningful autism treatment, provider networks – and jobs – will be created. Families will have access to care. Those receiving treatment will make social and behavioral gains to become contributing members of the community, reducing the burden on taxpayers. And health insurance premiums will be protected by language guarding against rate increases of more than 1 percent. Claims data from states requiring similar coverage shows an average premium impact of 32 cents per member per month – less than a postage stamp.

According to the Autism Society of America, autism is the fastest-growing developmental disability, affecting nearly 1.5 million Americans. In fact, one of every 88 children will be born with Autism Spectrum Disorder. Over the next 10 years, autism treatment is expected to cost between $200 million – $400 million. However, research indicates that early diagnosis and intervention can reduce the cost of lifelong care by two-thirds.

With appropriate treatment and clinical intervention, Georgia is projected to save more than $1 million per child. This is both morally right and fiscally conservative – in other words, a “no-brainer.”

On behalf of the families, interested stakeholders, legislators and health care providers who fought to make this legislation a reality, I plan to fight and make this bill the law in Georgia in 2014. I’m confident that Ava’s Law is sound legislation that will go a long way toward providing the care needed for early behavioral and cognitive intervention. I encourage you to reach out to the Georgia General Assembly and make your voice heard.

Georgia State Senator John Albers, R-Roswell, represents the 56th Senate District which includes portions of North Fulton and Cherokee counties.

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