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North Dakota becomes 48th state to make insurers cover autism treatments

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WEST FARGO – All insurance companies doing business in North Dakota will soon be required to provide coverage for autism spectrum disorders, the state insurance commissioner announced Wednesday.

A bulletin was issued Wednesday to insurers telling them that treatments for autism can’t be excluded from policies, Commissioner Jon Godfread said in a news conference at the North Dakota Autism Center.

Coverage must be in place by Oct. 1 for policies “grandfathered in” under the Affordable Care Act, Godfread said. Coverage for policies purchased on the open market must be available by Jan. 1.

“Today’s a great day!” Godfread said, adding that insurance carriers “are being very cooperative.”

North Dakota is the 48th state to require insurance coverage for autism spectrum disorders, said Lorri Unumb, vice president for state government affairs for the national group, Autism Speaks. Only Wyoming and Tennessee don’t require such coverage, she said.

Godfread said the increase in the cost of the average insurance policy-holder’s coverage is negligible, “the loose change in your car console” per month per person.

Unumb said in South Carolina, the cost is about 43 cents per member per month.

One in 59 children is estimated to be on the autism spectrum, the Centers for Disease Control and Prevention estimated in April. That’s about one in 42 boys and one in 189 girls.

About 1.5 million adults and children are on the autism spectrum in the U.S., Advancing Futures for Adults with Autism estimates.

The Global Autism Project defines autism as a pervasive neuro-developmental condition that affects a person’s ability to communicate and interact with others. People with autism may have a difficult time understanding typical social cues and behaviors, and they may face challenges engaging with those around them – either by using words or non-verbal behaviors. It manifests itself differently and to varying degrees with each person.

Intensive therapy can be expensive. Unumb said that when her son, now 17, was first diagnosed, the cost was $70,000 a year – more than she earned annually at the time.

But therapy can be life-changing.

Unumb said her son couldn’t go to restaurants, grocery stores or church when first diagnosed. With therapy, his “life changed dramatically” over time, she said. While not fully independent, “today, he goes everywhere.”

Sen. Judy Lee, R-West Fargo, said having the insurance department set the standard, rather than having the Legislature write the requirements into state law, provides more flexibility.

“This is a way better solution than a mandate,” Lee said.


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