Office of Speaker Dennis M. O’Brien

Pennsylvania House of Representatives

139 Main Capitol Building, Harrisburg

FOR IMMEDIATE RELEASE                                          CONTACT:  Bill Patton

                                                                                                                       717-787-4610

Autism insurance measure signed into law

HARRISBURG, July 9 – House Speaker Dennis O’Brien today looked on as Gov. Edward G. Rendell signed into law a long-sought measure to require private insurance coverage for the diagnosis and treatment of autism spectrum disorders in thousands of Pennsylvania children.

“This will end the categorical exclusion of autism services by private health insurance companies. It’s historic,” said O’Brien, the bill’s sponsor.

“A number of states require partial coverage of autism at very young ages, but Pennsylvania’s new law is now seen as the best. It gives our residents the best overall coverage of autism, all the way to age 21, and it gives other states something to strive to match,” O’Brien said.

The ceremony took place in Hershey at the Vista School, a state-of-the-art school serving children with autism.

O’Brien and Rendell were joined by Estelle Richman, secretary of Public Welfare; Nina Wall-Cote, director of the Bureau of Autism Services; Jim Bouder, chief operating officer of the Vista School; a dozen legislators; and about 100 parents and kids with autism who helped to pass the legislation.

The law (Act 62) requires private insurers to cover proven treatments of autism spectrum disorders for children and young adults up to age 21 beginning in July 2009.

“The Senate and House were able to work together and achieve the necessary wording that guarantees the substance of autism insurance coverage,” O’Brien said. “The new law’s precise definitions will ensure greater continuity of care for kids using both private insurance and the state’s Medical Assistance program.”

He noted that Act 62 includes definitions of behavior specialist, rehabilitative care, and applied behavioral analysis. ABA has been proven an effective treatment for thousands of children living with autism. This important element was sought by autism advocates from all over Pennsylvania.

The law exempts groups with 50 or fewer insured employees, but it requires coverage of autism treatment up to age 21 by state government insurance programs such as CHIP and adultBasic.

Act 62 also ensures that Pennsylvania’s Medical Assistance program will remain a safety net for these individuals and their families if the cost of covered services exceeds $36,000 in a year.

“Families who already pay premiums for health insurance ought to be able to get the care and services they need,” O’Brien said. “The new law will help insured families get the necessary tools to obtain an early diagnosis of autism spectrum disorders, resulting in better treatment and better outcomes at far less expense.

“Health insurance policies will meet the needs of policyholders and no longer exclude crucial services for thousands of children,” he said.

The Speaker thanked the many advocates in Pennsylvania and beyond who contacted legislators and educated them about the issue and the need for this insurance law.

“The tremendous and heroic grassroots effort directly contributed to the passage of the law,” he said.

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