Some Piedmont parents want autism insurance reform in NC

JAMESTOWN, N.C. — Some Piedmont parents are disappointed a bill proposing autism insurance reform was never brought up for a vote in this year’s short session in the senate.

Shea Capps’ son Holden was diagnosed with autism at age two. The treatment she’s told is best for him is called Applied Behavioral Analysis (ABA therapy).

“For him to get the therapy he needs, it would be anywhere from 40 to 60 thousand dollars a year, which we simply can’t afford,” she explained.

Right now, Holden is getting treatment at the ABC of NC Child Development Center in Winston-Salem.

Many of the parents there, including Capps, have visited Raleigh this year to introduce their children to Senators and express their support for the bill.

“This legislation would be life-changing for many of the families we serve who are making incredible sacrifices to get medically necessary treatments for their children with autism,” said Selene Johnson, Executive Director of ABC of NC.

“We remain hopeful that Senator Berger will bring this bill up for a vote in the Senate; we feel confident that if this bill reaches the Senate floor, we will have the votes to become the 38th state with autism insurance legislation,” Johnson added.

In a statement to FOX8 Monday, Senator Phil Berger said “The Senate is committed to keeping health insurance affordable for all North Carolinians – that’s why we have serious concerns about creating additional government mandates for insurance coverage, which history has shown can increase the cost of insurance coverage for families and small businesses.”

Senator Berger’s office also provided background information saying, “Government mandates force private health insurance companies to cover select conditions and specific treatments that support only some individuals while creating higher costs that are then passed on to all policyholders.”

It went on to say, “Under current law, insurance companies must offer coverage for medical expenses related to autism, including diagnosis and many therapies and treatments. House Bill 498 would require insurance companies to provide coverage for one specific treatment called Applied Behavior Analysis (ABA) and would affect a very small percentage of individuals who have been diagnosed with autism.”

National groups supporting broader autism insurance coverage estimate the increase to the average insurance policyholder would be about thirty-one cents in North Carolina.

Capps just wishes the issue could at least be brought up for a vote.

“It’s actually going to be more of a financial burden down the road if these children end up needing to be taken care of by the state,” Capps said. “But if we can get the treatment early on then they can live their best possible lives.”

1 Comment

  • Bo Diddley

    How and why would you force a private company to cover anything? The company has the right to determine the extent of their policy’s that they sell.

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