Parents laud state law covering autism

Christine Mostrom, a Nashua mother of a toddler with autism, said she expects the new law mandating health coverage for autistic children, signed by Gov. John Lynch on July 23, will make an immeasurable difference in her child's life.

Connor's Law, which will go into effect Jan. 1, requires insurers to cover behavioral, speech and occupational therapy for autistic children. While insurers were already required to cover medications and some psychiatric services for autistic children, most did not pay for therapies that studies suggest help afflicted children develop more typical behavior.

Mostrom said research indicates 47 percent of children treated early and intensively with behavioral therapies improve, and up to 20 percent can recover. A child is considered "recovered" when he becomes indistinguishable from his peers.

"Kids go from having to go to an institution when their parents die to being able to go to college, get married," Mostrom said. "It's like, if there was a child kidnapped today and you were guaranteed a 47 percent chance of having no harm coming to them and getting them returned, there is not a person or politician alive who wouldn't take it."

As the bill was debated in the House and Senate, detractors raised concerns that autism - the diagnosis of which has grown dramatically more common in recent years - affects too many children for insurers to tenably cover a wide range of treatments. Small businesses, they argued, would be crippled by the costs. Some legislators also worried that an amendment to the bill would extend prescription powers to psychologists and social workers.

Supporters maintained that the bill, if passed, would not be able to upend existing drug law. They also argued that it would save the state $597 million in long-term services while increasing insurance premiums by just $17 per year.

Under the law, medical professionals must submit a treatment plan to the patient's insurance company, which retains the right to question whether a treatment is necessary.

Mostrom recalled being told that her insurance company's hands were tied when her son went through a week of refusing to eat. The company could only intervene, she was told, if he were 48 hours away from death by starvation.

"Until now, this was a diagnosis that was discriminated against," she said, noting that getting insurance to cover treatment was made trickier by the importance of starting a child's treatment before the age of 3, when it is most effective. She and her husband could not afford to pay out of pocket, and they didn't have the luxury of time to consider other options and raise funds.

Most parents would "move mountains for their child," Mostrom said, but "the bottom line is, it comes down to money, and up until this point there was really no support for the middle class."

Linda Quintanilha, a Bennington mother of a 6-year-old with autism and a 5-year-old with pervasive developmental disorder (a similar disorder characterized by delayed development of communication skills), said that while her children's insurance plans would be unaffected, the law is a "step in the right direction."

"I think from my point of view, it just continues to show how active families need to be in the process, how we need to get out there and fight, because the insurance companies were fighting just as hard against this," she said.

The insurance requirement will only apply to policies regulated by the state. Self-insured pools and federally regulated policies are not subject to the law.

That means the new law will only affect about a third of the insurance market, according to Kirsten Murphy, administrative director for the New Hampshire Council on Autism Spectrum Disorders.

The state Medicaid plan - roughly a third of the market - is not included, and larger companies that are self-insured make up the other third. (next page »)