ND Autism Insurance Reform

There are 5 states in the entire country that do not have enacted autism insurance reform laws.

North Dakota is one of them.screen-shot-2017-02-07-at-1-50-53-pm

When Adam and I decided to take the job in Fargo, Sam did not have a diagnosis. As we ready ourselves for a move back to North Dakota, we have been confronted with antiquated North Dakota laws. There is no mandate in the state of North Dakota for autism insurance coverage. Which means an incredible cost to the families of children with autism.

It’s time to wake up North Dakota. It’s time to align with the majority of this country and stand by the proven treatment for autism–scientifically proven ABA (Applied Behavioral Analysis) coverage and coverage for children with autism throughout North Dakota.

Just last week, House Bill 1434 was passed in the ND House of Representatives. HB1434 is seeking to start the change— it would require state-regulated plans to cover evidence-based autism treatment for individuals under the age of 26 when prescribed by a licensed physician or licensed psychologist as medically necessary, including:

    • Therapeutic Services (speech therapy, occupational therapy, physical therapy)
    • Psychological, psychiatric and pharmacy care.
    • Behavioral health treatment (including Applied Behavior Analysis up to $50,000 per year)

What can you do?

The best way to help right away is to reach out to your state senators and tell them you support this bill and you support Sam Stibbe. HB1434 passed the House vote with overwhelming support. Our next hurdle is the State Senate. Here is a link to the ND senators…just find your district and call or email your representatives. Preferably, send an email to all of them 🙂 


Supporting information?

  • According to the CDC, autism now affects 1 in 68 children and 1 in 42 boys.
  • Coverage for evidence-based treatments are endorsed by the American Academy of Pediatrics and the U.S. Surgeon General.
  • 45 states have passed autism insurance reform legislation and a majority of the remainder are currently pursuing passage.    
  • The US Military (TRICARE), Federal Employee Health Plan (with 8 million members nationwide), and almost 40% of self funded plans also provide coverage.

“Why should I have to pay for something I won’t use?”

Yes, that is an actual argument that has been thrown around for years. Insurance exists to help people who have no intention of becoming sick. No one intends to get cancer, multiple sclerosis, or Autism.

Autism rates keep soaring, and there is only one scientifically proven method of treatment—Applied Behavioral Analysis.

Here is how this bill would actually lead to cost savings:

  • Actual claims data from other states that have required similar coverage for multiple years indicates an average premium impact of 31-49 cents per member per month — less than a cost of a postage stamp.
  • Approximately 250,000 covered lives in North Dakota have private health insurance regulated by state law.  These families and their employers have no access to meaningful autism coverage, even though they pay their health insurance premiums every month.

According to the Harvard School of Public Health, the incremental cost of caring for someone with autism over their lifetime is $3.2 million. The costs of treatments covered could be expected to be recovered through reductions in educational and medical expenditures alone.   (Oliver Wyman, 2011)  State estimated lifetime cost savings of providing appropriate treatment are $1 million per child.   (Jacobsen et al, 1998)


More about ABA:

How Does ABA Benefit Those with Autism?

Today, ABA is widely recognized as a safe and effective treatment for autism. It has been endorsed by a number of state and federal agencies, including the U.S. Surgeon General and the New York State Department of Health. Over the last decade, the nation has seen a particularly dramatic increase in the use of ABA to help persons with autism live happy and productive lives. In particular, ABA principles and techniques can foster basic skills such as looking, listening and imitating, as well as complex skills such as reading, conversing and understanding another person’s perspective.  (©2017 Autism Speaks Inc)


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