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Ga.: Commission on Mandated Benefits Focuses on Autism

By Diane Cadrain  8/7/2013
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A special commission on mandated health insurance benefits has started to take a hard look at the coverage that Georgia health insurers are required to provide, starting with benefits for treatment of autism. The commission has been charged with evaluating the social and financial impact of current and proposed mandated benefits and their impact on employers and insurers.

At its first meeting in June 2013, the commission heard from advocates on both sides of the autism coverage issue.

“They all have very compelling stories,” Kyle Jackson, state director of the Georgia affiliate of the National Federation of Independent Business told the commission, “but at some point we’re going to make health insurance so expensive, nobody’s going to be able to afford it.”

Opponents of the coverage maintain that the costs of treatment should be borne by parents and school systems. These can amount to $3.2 million over the lifetime of a person with autism, according to a 2006 study by the Harvard School of Public Health. For families paying out of pocket, treatment can cost anywhere from $10,000 to $75,000 a year.

As of August 2012, a total of 37 states and the District of Columbia mandated some form of coverage, according to the National Conference of State Legislatures.

In states that have mandated some form of coverage for the condition, according to the advocacy group Autism Speaks, the impact on premiums has been minimal. According to the group, after South Carolina enacted a mandate in 2008, the direct impact on premiums was less than $5.00 per year. Among other states that require coverage, the annual cost ranged from $1.20 in Illinois to $9.96 in Minnesota.

Diane Cadrain is an attorney who has been writing about employment law issues for more than 20 years
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