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Calif. law helps parents grappling with autism health insurance coverage

October 10, 2011 12:00:00 AM PDT
Victorville resident Julie Price is waging a battle against two fronts: autism and her insurance company.

For more than a year, she has asked and been denied coverage for a behavioral treatment for her 5-year-old son, who has autism.

Instead, she and her husband have tried to do it themselves.

"It's essentially somebody telling you read a book on dentistry and setup a practice and go at it," Price said.

That will soon change.

Gov. Jerry Brown signed SB946, requiring health insurance plans to provide coverage for children with autism or other developmental disorders. It goes into effect July 2012.

Senate President Pro Tem Darrell Steinberg, D-Sacramento, called the coverage "the difference between despair and hope" for many families.

Opponents say SB946 will increase health insurance premiums by millions of dollars just as many people and businesses are struggling to afford their insurance coverage during tight times.

However, it's welcome news for many parents who have struggled to pay for some of the services.

"It is taxing on your pocketbook and emotionally, and to know your family is going to have to overcome things you never expected, it takes a while to get your mind around it," said Troy Francis of Riverside.

According to the Centers for Disease Control and Prevention, 1 in 110 children has the disorder.

The most common treatment for it is applied behavioral analysis, or ABA therapy.

Insurance companies argue ABA therapy is not medical treatment.

The California Association of Health Plans issued a statement reading in part: "SB946 is going to drive up health care costs for families and businesses by nearly $850 million a year by transferring responsibility for educational services to health insurers."

Autism advocates disagree.

"This is the single most effective therapy for autism," said Beth Burt of the Inland Empire Autism Society. "It is a medical treatment. This impacts our children. It's a standard of care."

In the Inland Empire, 6,000 children diagnosed with autism will be eligible for coverage when the law goes into effect.

Price isn't waiting.

"This is going to be a wonderful thing and I already have my phone call into my senior case manager that just denied me last week," she said.

The Associated Press contributed to this story.

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