U.S. Senator Kirsten Gillibrand, a member of the Senate Armed Services Committee, today announced that the U.S. Senate passed the National Defense Authorization Act for 2013, which includes Gillibrand’s amendment that would cover behavioral treatment for military children with autism spectrum disorders and other developmental disabilities. Based on the USA Heroes Act that Senator Gillibrand authored and introduced in 2009, this bipartisan amendment under the 2013 National Defense Authorization Act (NDAA) bill would help reduce the burden of military families and their children living with autism and other developmental disabilities by requiring the military health insurance program to lift restrictions on behavioral care and expand proven treatment by meeting the national recommended standards.
“It is alarming that our military families who have sacrificed so much are denied essential services for their children suffering from autism and other developmental disabilities,” said Senator Gillibrand. “This legislation will help ensure that our military families have access to the critical services, care and support they desperately need and deserve.”
Autism is the fastest growing developmental disability in the country, with over 23,000 TRICARE beneficiaries diagnosed with autism, and another 10,000 families are estimated to have a dependent with a developmental disability. Nationwide, this disease affects 1 in 88 children and 1 in 54 boys, according to the Centers for Disease Control.
The current military health insurance program (TRICARE) does not cover applied behavior analysis (ABA), a treatment recommended for autistic disorders, leaving retirees and reservists and their families without care. Under the Extended Care Health Option (ECHO), available only to active duty personnel, ABA therapy is covered, but capped at $36,000 a year or an estimated 6 to 11 hours of therapy a week – a fraction of the care medically recommended to improve the life of a child suffering from autism.
As a result, tens of thousands of military families impacted by this disease suffer emotional and financial strain and are forced to choose between paying out-of-pocket or forgoing therapy altogether. Forced to rely solely on other coverage, families find themselves at the end of a long line waiting list for a specialist each time they relocate.
To ensure that military families have the care they need, Senator Gillibrand’s amendment would require TRICARE to meet the minimum threshold of basic care, cover behavioral treatment for developmental disabilities, including autism, modeled after national standards, and lift the financial cap on care. More than 30 states already have laws in place that require private insurers to cover ABA as a medically necessary health service and starting next year, federal civilian employees may see ABA-inclusive health benefits.
The amendment is co-sponsored by Senators Joe Lieberman (I-CT), Scott Brown (R-MA), John Kerry (D-MA), Richard Blumenthal (D-CT), Mark Begich (D-AK), Bob Menendez (D-NJ). Bernard Sanders (I-VT), Daniel Akaka (D-HI), Barbara Mikulski (D-MD), Patrick Leahy (D-VT), Sherrod Brown (D-OH), Saxby Chambliss (R-GA), and Marco Rubio (R-FL).
The National Defense Authorization Act for Fiscal Year 2013 will go to Conference with the House of Representatives, pass the full Congress and go to the President for signature.