Parents Pushing Insurance Coverage For Autistic Therapy
FORT WORTH (CBSDFW.COM) – Tying a shoe lace. Buckling a seatbelt.
Looking into the eyes of a mother and father…
And recognizing them.
They are simple accomplishments, usually taken for granted – unless you are the parent of an autistic child. For them, these child-like actions are miracles made possible, they say, because of a therapy known as Applied Behavior Analysis, or ABA.
The treatment is a regimen of intense human interaction, between trained specialists and children with autism. Parents, as well as respected members of the medical community, praise ABA as the reason why autistic children are beginning to speak and smile, showing signs of a promising future, rather than a life of silence and dead stares.
“There’s just been moments where I’ve felt like I’ve got my little boy back,” said Fort Worth youth minister Garrett Neuman, who, with his wife Melissa, has a 5-year-old son, Hayden, who is autistic.
“He runs up to me and wants to tickle me. He wants to wrestle now … They are just amazing moments, moments that as a dad you hope and pray for,” Garrett Neuman said.
But for the Neumans, as well as other families of autistic children who spoke with CBS 11, expressions of good feelings end when they describe their attempts to get insurance coverage for the ABA treatment.
Despite a Texas law that requires such coverage, some families have had to fight hard to get it; others continue to be denied; and still others simply give up trying because of bureaucratic red tape, a CBS 11 investigation has found.
Some of the state’s largest insurance companies declined interview requests for a comment on their reluctance, or complete denial, to cover ABA treatments for autistic children.
A spokesman for the insurance industry in Texas questioned, in an email to CBS 11, the legitimacy of ABA, even though it has been endorsed by the U.S. Surgeon General as an effective treatment for autism.
“ABA is not a proven therapy, not even close,” said Jared Wolfe, executive director of the Texas Association of Health Plans. “It is extremely time intensive and there is little evidence to support its effectiveness,” Wolfe said in the email.
He also questioned the prognosis of the disease itself, saying: “Diagnosis of autism is based upon observation only, and the definition of autism … is incredibly broad and vague.”
Families, who say they have seen remarkable improvements in their autistic children after ABA therapy, were rattled by the insurance industry’s response.
“I think that statement is from someone who hasn’t had to live our experience,” said Hayden’s mother, Melissa Neuman. Garrett Neuman added: “I think insurance agencies would rather have a pill – ‘Give him this pill; everything’s all better’ – and we pay for it one time.
“Autism doesn’t work like that.”
The Neumans finally got insurance coverage for their son, but only after a protracted battle that included switching insurance providers.
Jeff and Leticia Cureton are still fighting with their insurance provider for ABA coverage for their 4-year-old daughter, Analisa. Jeff Cureton, who is a federal magistrate judge in Fort Worth, and Leticia, a Tarrant County prosecutor, have been told that since their insurance comes from a “self-funded” provider, it is exempt from laws requiring ABA coverage for a child with autism.
The Curetons are skeptical. “I have read the benefits. I have read the contracts. There is nothing at all that says ABA is not covered,” Leticia told CBS 11’s Arezow Doost.
State Sen. Wendy Davis, a Fort Worth Democrat, says insurance companies are simply trying to duck their responsibilities, as mandated by law. She said she will work during this legislative session to strengthen the law, and to make insurance companies more accountable.
“There is no ignorance in this arena,” Davis said. “They’re very well aware that they’re required to cover it.”
Davis said she will also vote against current legislative proposals that could end the state’s assistance in funding ABA treatments for children in need. “On the state dollar side, we already aren’t doing enough,” she said.
Meanwhile, families like the Curetons and the Neumans say they will continue to campaign for a better awareness of what their children need, and deserve, for a good life.
“Things are coming together,” Garrett Neuman told CBS 11, his son Hayden playing near his side. “He can get dressed in the morning by himself. He can put his shoes on, gets in the car, does up his seatbelt,” Neuman said.
His eyes beginning to water, the father added: “If those little pieces of independence can keep going, my dream is that some day he will be a normally developed.”