[Note: Shared for #AutisticHistory archive purposes. This is NOT An Autistic Ally.]
New Mexico passes landmark legislation for autism insurance coverage
April 2, 2019
In celebration of World Autism Awareness Day, New Mexico Governor Michelle Lujan Grisham signed landmark autism insurance legislation.
Joined by members of the autism community, Governor Lujan Grisham signed House Bill 322 which expands coverage for autism therapies to transition-age youth and adults with autism covered by private, state-regulated health benefit plans as well as Medicaid.
New Mexico has set a new precedent by creating a statutory requirement for Medicaid coverage of autism therapies, including applied behavior analysis (ABA), regardless of an individual’s age.
New Mexico has had a Medicaid children’s ABA benefit since 2014. HB 322 will expand coverage to all state Medicaid recipients with autism spectrum disorder (ASD). Medicaid-eligible individuals with ASD served on the New Mexico Developmental Disabilities Waiver, as well as those on the waiting list for services and those who do not meet waiver criteria, will all now be able to access autism-specific services.
In addition, the new law removes all age and dollar caps from the state’s current autism insurance mandates.
New Mexico passed its original autism insurance mandate in 2009. However, coverage had been limited to individuals nineteen years old and younger or individuals twenty-two years old and younger who were still enrolled in high school. Furthermore, coverage for autism therapies was limited to $36,000 per year and $200,000 per lifetime. The state passed a public employee mandate in 2013 that also included age and dollar caps.
Effective June 15, 2019, individuals of any age will be guaranteed coverage for the diagnosis and treatment of autism, without limitations, under state-regulated health benefit plans.
“We are grateful for Representatives Elizabeth Thomson, Karen Bash, and Natalie Figueroa for sponsoring this landmark legislation,” said Lorri Unumb, Vice President of State Government Affairs at Autism Speaks. “Their leadership and the dedication of autism advocates throughout the state were instrumental in achieving this precedent-setting milestone.”
Joel Davis of the New Mexico Autism Society and Gay Finlayson of the University of New Mexico Center for Development and Disability assisted the sponsors in moving the bill through the committee process. Senator Linda Lopez carried the bill on the Senate floor on the last night of the legislative session.
According to Finlayson, who worked on all three insurance bills, the New Mexico autism community remained united and committed to autism insurance reform. “HB 322 completes a ten-year journey started by a grandfather, finished by a mom, and accomplished through grassroots advocacy, legislative action, and the willingness of three governors to honor our efforts,” said Finlayson. “This is an important step forward for New Mexico, and we are excited about celebrating our success on April
New Mexico requires meaningful coverage for autism under state regulated plans.
New Mexico’s autism insurance bill, SB 39, was enacted in 2009 and became effective on January 1, 2010. Enhancements to its initial coverage have been made since then. In 2013, HB 22 added coverage for state employees and became effective on January 1, 2015. In 2019, HB 322 removed age and dollar caps from the law, expanding coverage to transition-age youth and adults with autism. This expansion went into effect June 15, 2019.
To which plan types does the STATE autism insurance law apply?
- State Employee Health Plans – YES
- Individual Plans – YES
- Fully Insured Large Group Plans – YES
- Fully Insured Small Group Plans – YES
What services are covered by law?
- Screening and diagnosis
- Applied Behavior Analysis
- Speech, occupational and physical therapy
Does New Mexico have caps on ABA coverage?
No. Legislation passed in 2019 eliminated previous caps in coverage.
The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is a federal law that generally prevents group health plans and health insurance issuers that provide mental health or substance use disorder (MH/SUD) benefits from imposing less favorable benefit limitations on those benefits than on medical/surgical benefits. This includes quantitative treatment limits like age and dollar caps.
Where can I find more details about the New Mexico autism insurance law?
Click here for a copy of SB 39 (2009) as enrolled.
Click here for a copy of HB 22 (2013) as enrolled.
Click here for a copy of HB 322 (2019) as enrolled.
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.