[Note: Shared for #AutisticHistory archive purposes. This is NOT An Autistic Ally.]
Washington Becomes State #38 To Require Autism Benefits
November 15, 2014
NASHVILLE, TN — Autism Speaks welcomed Washington as the 38th state to enact autism insurance reform during the 9th annual Autism Law Summit held here today. Washington became the first state to require private insurers to cover medically necessary treatment of autism through litigation; the previous 37 states enacted specific insurance reform laws.
The Washington Autism Alliance & Advocacy (WAAA) teamed up with Seattle attorney Eleanor Hamburger in pursuing a series of successful state and federal class action lawsuits against Washington’s major insurance carriers as well as the state employees health benefit plan.
WAAA Founder Arzu Forough [left] and staff attorney Mira Posner celebrate in Nashville
The most recent case, OST v Regence, led to a unanimous state Supreme Court ruling directing Regence Blue Shield, the state’s largest private insurer to stop enforcing blanket exclusions for medically necessary mental health coverage, such as applied behavior analysis (ABA) for autism. Hamburger within days then announced she had reached a settlement with Regence of state and federal class action suits.
The proposed settlement would require coverage for medically necessary speech, occupational and physical therapies and ABA therapy to treat mental health conditions, including autism. Exclusions, age limits, monetary caps and visit limits would all be prohibited. A $6 million settlement fund would be established by Regence to reimburse policyholders whose previous claims for autism coverage were denied.
The Supreme Court decision then prompted state Insurance Commissioner Mike Kreidler to direct all state-regulated private health plans to provide coverage in 2015 and to reconsider all claims denied since 2006 on the basis of a blanket exclusion. The order also covers new health plans sold through Washington Healthplanfinder, the state’s Marketplace created under the Affordable Care Act.
The state and federal class actions were all brought on the basis that the blanket exclusions violate state and federal mental health parity law.
“We’ve always known that this was the law,” said Forough, who has two sons on the autism spectrum. “It’s been really gratifying watching these cases over the last six years clarify the law. But what really brings me joy is all the families who will not even know where this benefit came from. It will just be there.”
The series of class action lawsuits began when Forough, as a state employee, sued the Washington Health Care Authority for denying her sons’ needed autism treatment. Through WAAA, Forough then helped assemble plaintiffs for successful class actions brought by Hamburger against Regence, Premera Blue Cross and Group Health Cooperative. Earlier this year, a federal class action was brought against Boeing in a case that will involve self-insured, or so-called ERISA, employers.
In his letter to insurers issued last month, Kreidler directed that claims for medically necessary services could no longer be denied on the basis of blanket or categorical exclusions. If current insurance contracts do contain exclusions, then policyholders must be notified of the “correct coverage standard.” Health plans to be issued in 2015 will be reviewed for compliance.
“With this settlement and the recent (state) Supreme Court decision, the standard for coverage in Washington state is clearly established,” said Hamburger, of Sirianni Youtz Spoonemore Hamburger.
During the law summit, the Washington state representatives celebrated with advocates from Utah and Nebraska, which also enacted reform laws in 2014. Kansas and Maine were also honored for expanding their original autism insurance reform laws.
The Autism Community Is Not The Autistic Community
More With Autism Votes
Autistic people have fought the inclusion of ABA in therapy for us since before Autism Speaks, and other non-Autistic-led autism organizations, started lobbying legislation to get it covered by insurances and Medicaid.
ABA is a myth originally sold to parents that it would keep their Autistic child out of an institution. Today, parents are told that with early intervention therapy their child will either be less Autistic or no longer Autistic by elementary school, and can be mainstreamed in typical education classes. ABA is very expensive to pay out of pocket. Essentially, Autism Speaks has justified the big price tag up front will offset the overall burden on resources for an Autistic’s lifetime. The recommendation for this therapy is 40 hours a week for children and toddlers.
The original study that showed the success rate of ABA to be at 50% has never been replicated. In fact, the study of ABA by United States Department of Defense was denounced as a failure. Not just once, but multiple times. Simply stated: ABA doesn’t work. In study after repeated study: ABA (conversion therapy) doesn’t work.
What more recent studies do show: Autistics who experienced ABA therapy are at high risk to develop PTSD and other lifelong trauma-related conditions. Historically, the autism organizations promoting ABA as a cure or solution have silenced Autistic advocates’ opposition. ABA is also known as gay conversion therapy.
The ‘cure’ for Autistics not born yet is the prevention of birth.
The ‘cure’ is a choice to terminate a pregnancy based on ‘autism risk.’ The cure is abortion. This is the same ‘cure’ society has for Down Syndrome.
This is eugenics 2021. Instead of killing Autistics and disabled children in gas chambers or ‘mercy killings’ like in Aktion T4, it’ll happen at the doctor’s office, quietly, one Autistic baby at a time. Different approaches yes, but still eugenics and the extinction of an entire minority group of people.
Fact: You can’t cure Autistics from being Autistic.
Fact: You can’t recover an Autistic from being Autistic.
Fact: You can groom an Autistic to mask and hide their traits. Somewhat. … however, this comes at the expense of the Autistic child, promotes Autistic Burnout (this should not be confused with typical burnout, Autistic Burnout can kill Autistics), and places the Autistic child at high risk for PTSD and other lifelong trauma-related conditions.
[Note: Autism is NOT a disease, but a neurodevelopmental difference and disability.]
Fact: Vaccines Do Not Cause Autism.