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Governor signs bill mandating insurance for autism care

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ALBANY -- Following years of debate and false starts, Gov. Andrew Cuomo signed a bill Tuesday requiring insurers to cover screening, diagnosis and treatment of autism.

"The children will get the help, the families will get the support," Cuomo said before signing the measure, which was passed by lawmakers last session.

The law could save families with autistic children tens of thousands of dollars, although it will likely contribute to an increase in health insurance premiums in the state. The law takes effect on Nov. 1 of next year.

Some 30,000 state residents under age 19 have been identified with an autism spectrum disorder, the term used for a wide range of autistic behaviors and symptoms.

The law makes New York the 29th state nationally to require that insurers cover autism-related expenses.

A complex neuro-biological disorder, autism inhibits a person's ability to communicate and to develop social relationships, according to Autism Speaks, a group that has long pushed for the insurance coverage.

Autism Spectrum disorders, which cover varying degrees of the conditions, are diagnosed in one in 110 children in the United States and one in 70 boys, according to the group. And while there has been controversy about how it is diagnosed and recognized, the number of cases has risen 600 percent in the past two decades.

People with autism may exhibit odd and repetitive behaviors. The cause of the disorder is unknown, as is the cure.

Debate over whether insurance companies should be required to cover autism dates back several years. A similar bill was passed in 2010 but Gov. David Paterson vetoed the measure amid concerns about its cost.

This time, Cuomo said the varying parties reached a breakthrough when they agreed insurance companies would have a $45,000-per-patient annual cap on reimbursements.

Cuomo and others noted families can easily run up bills of $50,000 or more per year in trying to get help for an autistic child.

Still, insurers said the measure will likely result in higher premiums, both in the private and public sectors.

"This measure will mean an increase of hundreds of dollars to the average family premium and tens of thousands to the costs employers pay for coverage for their employees," predicted Paul Macielak, president and CEO of the NY Health Plan Association which represents insurers.

Additionally, the mandate will increase costs for state-subsidized insurance programs such as Child Health Plus or Family Health Plus.

Autism Speaks, however, said they believe the bill could save taxpayers $13 million over six years by reducing Medicaid costs as well as the monies needed for early intervention and special education programs for autistic students.

Macielak said his group wants to amend the measure to reduce the scope and cost of the mandate and such discussions will likely take place in the coming year.

Regardless of finances, Tuesday's bill signing was an emotional one, with families of autistic children present in the Capitol's ornate Red Room where the event took place.

Lawmakers also related personal stories of how the disorder has touched some of their families.

Rochester Democratic Assemblyman Joe Morrelle, who with Long Island Republican Sen. Charles Fuschillo, sponsored the measure, said his chief of staff has an autistic child. And Saratoga Republican Sen. Roy McDonald, who has also fought for the measure, noted he has two autistic grandsons, age 7 and 9. "It's emotional," he said. "We've got to be there for people."

Reach Karlin at 454-5758 or This e-mail address is being protected from spambots. You need JavaScript enabled to view it .


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