RALEIGH, N.C. — Several Piedmont families were in Raleigh Wednesday, speaking to lawmakers about a proposed bill requiring insurance companies to cover autism therapies.
“For parents of children dealing with autism, it can be $60,000 a year out of pocket for these necessary treatments. Medically prescribed treatments,” explained Liz Feld, president of Autism Speaks.
Currently, North Carolina insurance companies are not required to cover Applied Behavioral Analysis, or ABA, therapy. It’s called the “golden standard” of successful treatment for patients with autism.
Feld visited Raleigh from New York to speak with Senators about a measure that originated as HB498 and is now also before the Senate in SB493.
It passed the House two years ago and is still waiting for a vote in the state Senate.
“We need to make sure the insurance companies don’t win this fight. Families need to be covered,” Feld insisted. She said 37 other states and the District of Columbia have already passed such legislation.
Wendy and John Mies are from Greensboro. They were in Raleigh to share their son’s story. He was diagnosed two years ago when he was three years old.
“I had to reinforce the bed he was rocking so hard. He was hurting his back. He was hurting his little brother. It was not good. It was a nightmare, frankly,” John said.
The couple said after getting their son ABA treatment at ABC of NC Child Development Center and Autism Clinic, the transformation was miraculous.
“A year and a half later, he’s a completely different child,” said Wendy. “He hasn’t even started kindergarten yet and is considered academically gifted. He’s been reading for two years, he taught himself. He’s doing multiplication and fractions; he can speak some Chinese and Spanish.”
Treatment is especially effective between birth and five years old, Feld said, increasing the opportunity for the child to “mainstream” into a public school classroom setting.
John pointed out, “There are kids who are in that period right now where their lives could be changed. And we are potentially losing them because we are dragging our feet.”
FOX8 talked to Senator Joyce Krawiec (R) who represents Forsyth and Yadkin Counties.
Krawiec said she and most senators don’t like the idea of “mandates,” but she fully supports autism insurance coverage.
“There are many of us on both sides who are very supportive of it,” she said. “I just see it as an investment for the future of our state that these children are going to be able to lead productive lives rather than being a burden on society.”
Krawiec said it’s up to Senate leadership to bring the bill forward for debate and a vote.
The time left in this year’s short session is ticking away.
“Whether or not we’ll get to hear it and take a vote on it, I have no idea. I’m working really hard to make that happen, and I would love to see it happen,” Krawiec added.
Opponents of the bill sometimes argue the treatments are educational in nature.
Autism experts and psychologists tell FOX8 the diagnosis and treatments are evidence-based and medical in nature, not simply educational.
They compare it to medication for diabetes or heart disease, and say insurance companies should cover it as they would insulin or prescription pills.
Wendy hopes senators are able to vote this year so other families have access to ABA therapy, which helped a young boy who’d never asked or answered questions before this treatment.
“I will forever remember the moment my son said to me, ‘Mommy, do you want to play a game with me?’ That never gets old. That just never gets old. It’s a gift. And we want to make sure every child has that opportunity,” she said.