Law Ensures Coverage for Vermonters with Autism

New Law Called One of the Strongest Laws in the Nation

For years we have talked about – and moved towards – a new health care system in Vermont; one where everyone is in and nobody is out. But, until now kids with autism have essentially been shut out. Even when their families have faithfully paid costly insurance premiums, if a child was born with autism, the insurance company simply said no. So, many families went without help, while those who could afford it paid out of pocket. There have been ongoing debates about defining the condition and more about defining the therapies; all of it costly and unfair.

A bill I wrote this year, changes things dramatically. It ensures Vermonters with autism and other developmental delays receive the therapies they need to address their condition and improve their quality of life.

Under the new law, all insurance programs in Vermont – private insurance, state funded and Medicaid – will cover medically necessary, evidence based therapies, provided by certified, licensed therapists, for Vermonters up to the age of twenty-one. This includes services like speech therapy and behavioral health therapies provided in a variety of settings. Since it is based on medical necessity rather than a specific diagnosis it allows services to be accessed based on need, be it autism or another developmental delay. And, providing early intervention takes some of the burden off of schools and families and ensures success later in life.

This would not have happened without the hard work of parents. They were intelligent, persistent and courageous in helping legislators understand the issues and craft a workable solution. Many of them had worked towards this victory for years, advocating for their kids while juggling the responsibilities of home, work and a unique special child. The Shumlin Administration was also supportive and we worked closely with Secretary of Human Services Doug Racine and his staff.

It was a true pleasure to bring these folks together and to know that we are ensuring these important therapies will be available to our neighbors who need them.

National autism advocates say it is one of the strongest laws in the country. It is also a significant victory for the families who helped make it happen.