Virginia autism bill removes age limit for private insurance coverage

In a move that will help tens of thousands of Virginia families, Gov. Ralph Northam signed legislation Tuesday that massively expands insurance coverage for children with autism.

Previously, insurers were able to opt out of ongoing coverage for children with autism after they turned 11, but after years of advocacy, that cap has been eliminated. The new bill will provide coverage for necessary care for all individuals with autism, regardless of age, under state-regulated group plans beginning in January 2020.

If you’re wondering what the tangible impact will be, consider the story of Jacob Korte, a 4-year-old with autism. As WWBT in Richmond reports, Korte goes through intensive therapy sessions, which teach him skills such as toilet training and how to respond to his own name, but the therapy is expensive.

Many insurance companies consider autism a condition that cannot be remedied, and before this law, insurance companies could have opted out of ongoing coverage for Jacob once he turned 11.

This would have made the critical therapy prohibitively expensive for Jacob’s family, as the average rate for behavioral therapy is $200 per hour, according to WWBT.

But the new law does away with the age cap, meaning Jacob and other children like him will be able to continue to receive the therapy at an affordable rate long after turning 11.

The legislation marks a huge moment for advocates, who fought for years to raise the cap to 10 years old and now to do away with it altogether.

As a result, tens of thousands of Virginia families can rest a little easier, knowing their children with autism will continue to receive the health care coverage they need.