Ohio Governor Issues Directive for Insurance Plans to Cover Services for Autism

Recently, Ohio Governor John Kasich announced a directive for insurance plans to include services for autism.  The directive requires insurance plans to include specific treatments, such as, speech and occupational therapy, initial assessments, psychiatric appointments, and other related therapies to treat those diagnosed with an autism spectrum disorder.  More specifically, the insurance plan must cover up to 70 therapy sessions per year and 20 hours of Applied Behavioral Analysis treatment per week.  This directive follows 32 other states that have mandated coverage for autism related services that insurance companies were not previously required to cover. Further, Governor Kasich has advised that State employee health plans will include services for autism by 2014.  This means that 49,000 state employees and approximately 40,000 children covered under state insurance plans will be eligible for benefits. 

The directive comes after the Ohio General Assembly had been debating the issue for several years after a bill was introduced and has yet to take a vote.  Ohio already provides access to autism related services to children through its medicaid program.  Research has shown that early intervention and therapy treatment helps make a significant long-term difference in the lives of children with autism by improving speech, social, occupational, and cognitive skills.

Governor Kasich’s directive was not without criticism from special interest groups.  Some folks are concerned that adding such a benefit will increase the cost of insurance to employees and employers.  Due to the additional cost of coverage and the amount of benefits insurance companies will be paying out will force insurance companies to increase the cost that will be passed down to the consumer. 

“These things aren’t free”, said Roger Geiger, who is the vice president and executive director of the National Federation of Independent Business in Ohio.  “They are all noble and sound good, but at some point it’s the straw that breaks the camel’s back.  Do you want basic coverage for many or Cadillac coverage for a few?”

An estimated 60,000 Ohioans have an autism spectrum disorder and the numbers are rising.  The U.S. Centers for Disease Control and Prevention estimated that 1 in 88 children have an autism spectrum disorder, which is an increase from 1 in 150 just five years ago.  Being a state employee and the father of a child with autism, I applaud Governor Kasich’s bold step to provide insurance coverage.  With that being said I fully anticipate lawsuits being filed to stop the Governor’s directive and an argument for the Ohio General Assembly to make the decision to cover autism services or not.