The Virginia House of Delegates passed legislation during the Tuesday session to lift the age cap on autism health coverage. Therefore, the approximately 10,000 Virginians with autism could very soon have expanded access to healthcare, requiring health insurance plans to cover treatment, regardless of the patient’s age.
Under current Virginia law, insurers must cover treatments for autism spectrum disorder (ASD) from ages two through 10. This limitation has proven difficult for families, as the average age of diagnosis is between six and seven years of age, according to a report from VCU’s Autism Center of Excellence. The report noted that many children have access to only two or three years of treatment before their benefits run out.
Currently, ASD is the only medical condition subject to coverage limitations based on the age of the patient. This restriction applies only to ASD, setting it apart from every other condition, such as asthma, diabetes, and cancer, in which coverage is based upon medical necessity, rather than the patient’s age.
“As a father of eight I know just how important ensuring children have access to quality healthcare is,” said Delegate Bob Thomas (R-Stafford) in a press release. “Children did not choose to be born with Autism. We should do everything we can to continue to learn about the causes — but also provide treatment for those diagnosed regardless of age.”
H.B. 2577, introduced by Delegate Thomas, which will lift the age restrictions, passed with a 97-vote majority in the House of Delegates.
While some opponents have said the move would be costly to the Commonwealth, a financial impact statement prepared by the Department of Human Resource Management estimated the total cost to Virginia to be only $237,000, of which only $118,500 would come from the Commonwealth’s General Fund.
Parents of children with autism have noted that expanded access to personalized treatment would better prepare their children to find meaningful careers, helping increase self-reliance when children come of age. Ultimately, they hope, this will lead to reduced utilization of social services, saving Virginians money when more children with autism enter the workforce.
“Many of these children are not diagnosed until they are already six or seven years of age and need access to important care for longer than just three or four years,” said Speaker of the House Kirk Cox (R-Colonial Heights). “This piece of legislation has been a long time coming and I am proud of the House for taking this step to guarantee those on the Autism spectrum have access to much needed healthcare.”
Every General Assembly session, families and advocates have descended on the Capitol in Richmond to share with lawmakers their stories of how access to treatment would make a positive impact in their lives. Now, Virginians with autism will have a chance to benefit from expanded healthcare coverage that will help them live better, healthier, and more productive lives.