Kasich Adds Autism Benefits in Ohio EHB Plan

Ohio Governor John Kasich has included coverage for the treatment of autism in the state's Essential Health Benefits (EHB) benchmark plan, drawing immediate praise from Autism Speaks. 

Recognizing the importance of effective intervention for individuals with autism, Kasich's decision guarantees that Ohioans with autism will have access to meaningful health insurance that includes coverage for Applied Behavior Analysis (ABA) when purchased through Ohio’s federally managed exchange beginning in 2014.  

“Autism Speaks commends Governor Kasich for his bold leadership and his commitment to supporting the autism community of Ohio,” said Lorri Unumb, Esq., Autism Speaks vice president of state government affairs. “Governor Kasich has listened to Ohio families impacted by autism and has responded decisively.”

After consultation with legislative leadership and members of both chambers who recently heard testimony on bills to require private health insurance to cover ABA for autism, Kasich made the further decision to make autism benefits available to Ohio’s state employees. Ohio is one of 18 states that currently do not require state-regulated health plans to cover ABA.

Unumb said Autism Speaks will continue to press for full autism insurance reform in Ohio in 2013.

The EHB benefit would cover 20 hours of ABA weekly, 20 visits per year for speech and language therapy, 20 visits per year for occupational therapy and 30 visits per year for mental/behavioral health outpatient services performed by a licensed psychologist, psychiatrist, or physician. The public employee benenfit will require negotiations with Ohio's five public employee unions.

According to an Autism Speaks’ analysis of state EHB benchmark plans, at least 22 of the 32 states that do require private health insurance to cover ABA for autism have included this benefit in their EHB benchmark plan.  Unumb called on other state governors to follow Kasich’s lead and add autism benefits to their EHB benchmark plans, even in states such as Ohio where this benefit is not currently required by law. 

“Autism is a national public health crisis, and providing access to meaningful health insurance coverage for the treatment of autism is a fiscal and moral imperative," Unumb said. "I think many of our nation’s governors understand this, but time is running short. I urge them to quickly add autism benefits to their exchange plans, whether or not they plan to operate their own exchange or select their own benchmark.”

Any state that proposes a benchmark that does not include all 10 EHB categories required under the Affordable Care Act must supplement the benchmark and may add autism benefits in the process.  The U.S. Department of Health and Human Services has proposed a deadline of December 26, 2012 for states to provide the list of benefits they intend to include in EHB benchmark plans.