Bill would require insurance to cover children with autism

11:44 PM, Feb 20, 2013   |    comments
Emma Guitard, and her father J.D. play together on an iPad
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Six-year-old Emma Guitard loves the color pink, the "Backyardigans" cartoon show, and her family.

"She is a sweetheart. She is so loving," says her mother, Christy Guitard. "She will give you a smile, a hug, and a kiss."

Guitard says her daughter is also a hard worker when it comes to her treatment.

Emma started showing signs of autism around the time she turned a year old, and doctors diagnosed her soon after. Non-verbal, and requiring help with many daily tasks, Guitard says Emma falls on the more severe end of the autism spectrum.

Doctors instructed Guitard to have her daughter in therapy at least 40 hours each week.

The family soon learned how much that would cost them.

"I was very shocked to find out that our insurance, which is a very good insurance plan through my husband's work, but it did not provide any coverage at all for autism," Guitard said.

She says her family is covered under Blue Cross, Blue Shield. She says the plan will allow Emma 30 combined speech and occupational therapy visits per year, far less than the doctor's order. That help comes only after the family meets its deductible, and they still face a co-pay.

"Of course we had to provide these things for our daughter, so it became a matter of, okay, what can we go without this month to able to afford even 10 hours of therapy? [That] was the absolute maximum we can afford, and that still was $2,000-$3,000 a month."

According CDC estimates, one in 88 children are diagnosed with an autism spectrum disorder.

With those numbers in mind, this month state lawmakers filed legislation that could help families like the Guitard's better afford autism treatment. SB 1286, Sponsored by Senator Jim Tracy (R-Shelbyville), would require health insurance policies to cover screening, diagnosis, and treatment of autism spectrum disorders.

"Many of these young people that have autism can grow up to be productive citizens if they get the right kind of treatment," Tracy explained by phone to 10News Wednesday afternoon. "Treatment is very expensive. If the insurance companies cover that treatment, they have an opportunity grow up, and work, and be involved in society."

Tracy says lawmakers are still working to determine the cost of implementing this legislation.

"I think people are waiting to get a fiscal note on it to see what the costs would be to the insurance companies. Then, once it goes down that way, that's when we'll start addressing those issues," he said.

Co-sponsor of the bill, Senator Jim Kyle (D-Memphis) told the Tennessean if passed, the coverage would begin in 2014, meaning the costs might be picked up by the Affordable Care Act.

Guitard says the treatment her daughter gets now has resulted in noticeable improvements.

"We saw tremendous gains, she makes eye contact now," she explains. "She's able to be held, and loved, and touched."

Now working as an advocate for the bill, she hopes its passage could bring even more success for her daughter's future.

"To know that my daughter is getting what she needs so that she can become a productive member of our society, so that she can grow to be a taxpayer," she said. "You want your child to be happy. You want your child to be able to grow up and know that, with each of their days, they can make a difference."

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