How Obamacare Affects Families Living With Autism

obamacare-logoLove it or hate it, Obamacare is here. The Patient Protection and Affordable Care Act or ObamaCare as it is popularly called is the largest health care expansion since the passage of Medicare in 1965. Americans will now have access to a variety of health care plans via federal and state exchanges. It is too soon to tell whether the new law will be a success or a failure, but for families caring for loved ones with autism, the new provisions could be a great help, or not.  Autism Daily Newscast reported back in August some of the potential impacts on families with children on the autistic spectrum.

On the plus side, insurance companies will no longer be able to deny coverage to individuals due to pre-existing conditions, which is a boon for those who suffer from autism, along with countless other medical conditions. Families will also be able to keep their adult children on their policies until the age of 26, which will be helpful since the unemployment rate for adults with autism is very high. Wellness checks will also be covered, which can help families manage their children’s health through preventative care and early detection of conditions that can lead to bigger problems down the road. Obamacare also emphasizes the availability of community clinics, where families can access health care without needing to travel long distances. This will be especially helpful to low-income families, who often live in communities with fewer health care facilities than higher-income areas. The cost and inconvenience of traveling long distances for doctor visits can be a real burden, especially on low-income families trying to travel with a child who suffers from autism.

However, there are also drawbacks to the new law. Current treatments for autism, including Applied Behavior Analysis (ABA), are costly and time-intensive, and there is no guarantee that they will be covered under Obamacare. The federal government declined to institute a national standard for the coverage of autism treatment until 2016, so for now, the decision remains with the individual states. Currently, 34 states have mandates to cover autism treatments, and only 24 have applied the same requirement to apply to policies sold under the public exchanges.

Numerous studies have shown that early intervention can dramatically improve outcomes for children diagnosed with autism. The American Medical Association, the American Academy of Pediatrics, and the U.S. Surgeon General all endorse early, intensive Applied Behavior Analysis as a useful treatment in improving outcomes for children with autism. Low-income children are already less likely to get an early diagnosis, or to have access to the interventions that can make such a difference. Experts agree that early intervention is best, and for those who must wait three more years before the federal government is willing to step it, it could be too late.

Insurance companies argue that interventions such as Applied Behavior Analysis are educational, rather than medical, and that covering these therapies will result in higher insurance premiums for everybody. However, the rate of autism continues to rise, and without intervention, most of these people will grow up into adults who will need constant care and supervision. Many argue that early intervention is a worthy investment that will decrease the pressure on social services further down the road.

To help understand the basics of Obamacare, Autism Daily Newscasts presents this education video from The Kaiser Foundation.