State considers autism parity

• Gates and son

Gates and son

Talk about it

BISMARCK — A Dickinson father wants kids like his 8-year-old son to be able to get the help they need.

Nick Gates is pushing for “Noah’s Law,” which would require health insurance coverage for autism spectrum disorders. The bill draft applies to those under the Public Employees Retirement System.

Gates, who works for the Dickinson Police Department, testified Tuesday before the legislative Employee Benefits Programs Committee.

Gates said his son was able to get some therapy, but not the social and behavioral therapy he needs because insurance wouldn’t cover it.

North Dakota is one of five states that hasn’t introduced a bill that would change how autism spectrum disorders are treated in the state, he said.

“The way I see it, things need to change in North Dakota,” Gates said.

The Centers for Disease Control and Prevention estimates one in 110 children has an autism spectrum disorder, a group of developmental disabilities that can cause significant social, communication and behavioral challenges.

With that statistic and North Dakota birth rates, Gates told lawmakers that 81 North Dakotans born in 2008 will be diagnosed with autism.

Sen. Carolyn Nelson, D-Fargo, who has a grandson with autism, said she and Sen. Rich Wardner, R-Dickinson, are supporting the bipartisan legislation.

The bill draft would require insurance companies, nonprofit health service corporations or health maintenance organizations to provide coverage for the diagnosis and treatment of autism spectrum disorders.

Coverage would be limited to treatment prescribed by a physician in accordance with a treatment plan.

The bill also states coverage could not be terminated or refused solely because the individual is diagnosed with an autism spectrum disorder or has received treatment.

Peter Roverud of Minneapolis-based Deloitte Consulting told lawmakers an estimated 85 Public Employees Retirement System members would receive treatment for autism spectrum disorder at a cost to the plan of $25,000 to $35,000.

This would equate to a per-member per-month cost of $3.08 to $4.31, or about $2.1 million to $3 million annually, he said.

Lawmakers also heard from Lorri Unumb, a South Carolina-based senior policy adviser and counsel for Autism Speaks.

Unumb, whose 9-year-old son has severe autism, travels the country to help families pass autism health insurance legislation.

Autism is a medical condition through no fault of the family and diagnosed by medical doctors, she said. Studies have shown applied behavior analysis therapy can help children. However, it must be administered intensively and is expensive, Unumb said.

Her family moved to a different home to help afford the $60,000 per year out-of-pocket costs for therapy, she said.

“How many North Dakota families do you know who could make that kind of sacrifice or come up with that kind of money?” Unumb said. “I think it’s sad that, in the United States of America, we know of a treatment that works for a disorder and yet if you’re not lucky enough to be born into a wealthy family, you don’t get it.”

Twenty-three states have passed legislation requiring insurers to pay their part, Unumb said.

Committee Chairman Rep. Bette Grande, R-Fargo, said Tuesday’s hearing was an opportunity to hear testimony. The committee will discuss the bill further at its Oct. 26 meeting.

Finneman is a multimedia reporter for Forum Communications Co.

Tags: health, news, autism, parity, health, insurance, north, dakota, local