ST. PAUL — After years of fighting for greater support for individuals with autism, Brad Trahan said there is growing momentum among state lawmakers this year to take action.
The founder of Rochester's RT Autism Awareness Foundation is chairman of a bipartisan state task force asked to develop a strategic plan for addressing the issue of autism in the state. Last week, Trahan presented the report to DFL Gov. Mark Dayton's staff and legislative leaders.
Among the group's recommendations is a requirement that state-regulated insurance companies cover medically prescribed therapies for children with autism — including an intensive, one-on-one therapy known as Applied Behavior Analysis. Without help from their insurance coverage, many families end up unable to afford the treatments, which can cost tens of thousands of dollars a year.
"We are still fighting our insurance companies when we have clear data that the one thing everyone agrees on, whether you are an insurance provider or an advocate, that early intervention will improve the quality of an individuals' life," Trahan said.
One out of every 88 children is diagnosed with an Autism Spectrum Disorder, a group of developmental disabilities that can cause social, communication and behavioral challenges, according to a 2012 study by the U.S. Centers for Disease Control.
The battle for insurance coverage is a very personal one for Trahan. His son Reece was diagnosed with autism at age 2. With little support available, he and his wife Joanie founded the RT Autism Awareness Foundation with the goal of providing information and support to other families dealing with autism. They have also continued to wage their own battle to get their now 12-year-old son Reece the care he needs. Despite having a Mayo Clinic psychologist prescribe the intensive ABA therapy for their son, the family's insurance company has refused to pay for it. Eventually, the family could no longer afford the cost of the treatment and pulled their son out.
Norton, Senjem support bill
The push to require insurers to cover this care has the strong support of two Rochester lawmakers — Assistant House Majority Leader Kim Norton and Sen. Dave Senjem. Norton introduced a bill four years ago to require insurance companies to pay for prescribed autism therapies. The bill has repeatedly stalled, faced with opposition from insurance companies and business groups that argue such a mandate would drive up health care costs. But the Rochester Democrat is optimistic that the bill will clear the DFL-led Legislature this session and notes more than 30 other states have already passed similar legislation.
Norton said she will also push to have autism therapy coverage be part of the state's essential benefits set under the Affordable Care Act. That is the basic amount of coverage that insurance plans have to offer in order to sell insurance as part of an online state health insurance exchange that takes effect in 2014.
Mike Hickey, a lobbyist for the National Federation of Independent Business, said the group will fight the proposal. He said the requirement unfairly targets small business owners who rely on these state-regulated insurance plans while larger employers who are self-insured are exempt.
"It's very expensive and obviously there is a really compelling need, but the fact that we are doing this to struggling small businesses and not covering the Fortune 500 companies is just an inequity we cannot swallow," he said. "That this would be crammed down our throat and not the Mayo Clinic's health plan? It's unbelievable."
Not all business groups oppose the legislation. Rochester Area Chamber of Commerce President John Wade said his organization differs with the state chamber and supports the mandate after studying the issue and the impact autism has on families. Wade has offered to testify in support of Norton's bill at the Capitol.
Senjem has learned more
Senjem is the first to admit he didn't know much about autism when he was elected to the Legislature a decade ago.
"I would dare say I came to the Legislature maybe not really understanding what autism is," the Rochester Republican said.
But over time, he said he has had a chance to learn more about the issue and served on the recent Minnesota Autism Spectrum Disorder Task Force.
"I've just got a new appreciation for the difficulties that autism brings forward within a family and moreover perhaps the opportunities that exist to get these kids into therapy at a young age, and it's seemingly life changing," he said.
The Minnesota Autism Spectrum Disorder Task Force lists among its top priorities doing a better job linking people with autism and their families to resources in their community.
The group has recommended the state establish a website to provide a one-stop shop for families of those with autism to get connected with local service providers. The group has also recommended establishing an autism commission and authorizing special autism license plates to raise money for the website and the commission.
The plan also lays out goals aimed at ensuring timely diagnosis of individuals, access to quality information, improved coordination of services and an emphasis on helping individuals transition to adulthood.
Pilot program in Olmsted
While not specifically part of the task force's recommendation, Rep. Mike Benson, R-Rochester, has introduced a bill to seeking $60,000 to set up pilot program in Olmsted County to provide employment counseling for high-functioning individuals diagnosed with Autism Spectrum Disorder.
These individuals often struggle with social issues they encounter at work. The idea would be to provide some support to help them navigate these issues and remain employed.
Benson sponsored the legislation last session, but time ran out to get it passed. He said he expects House Assistant Majority Leader Kim Norton, DFL-Rochester, will end up carrying the bill because she is a part of the majority party, which would boost its chances of passing.
DFL Gov. Mark Dayton's spokeswoman Katharine Tinucci said the governor has not had a chance to review the task force's recommendations. But she said in a statement that "autism is a topic that the governor cares deeply about, and I expect that we will engage on this topic in this legislative session."
Task force's chairman Trahan said members did have a chance to sit down with the governor this summer and he is optimistic these recommendations will have his backing. That includes a proposal to require state-regulated insurers to cover autism treatments.
"Let's just say this is the most momentum we have had for this legislation," Trahan said. "It's on Gov. Dayton's radar. I think that's fair to say."