Ore. judge's ruling big win for autism community

Insurers required to cover behavioral treatment

Big win for autism community

BEND, Ore. - A federal judge in Portland ruled this week that health care providers cannot deny coverage to autistic children for applied behavioral analysis treatment.

It's a huge win for the autism community.

"My son enjoys being out in the world. He likes being with people, socializing," said Jill Sauter, whose son has autism and underwent years of ABA therapy. "He can talk really well, he can write, he can type, he can play the piano. "

That was not always the case for her son, Derek Sauter.

"Our son wasn't able to go out in public. We weren't able to do anything as a family," Jill Sauter said.

The solution for the Sauters was ABA. It's designed to help children with autism catch up developmentally to their peers.

"It's all about social skills, communication, daily living skills, but also addressing some of the challenging behaviors that for some individuals with autism can be really harmful, such as self-injury," said Jenny Fischer, a behavioral analyst.

But ABA therapy is costly - up to $50,000 per year.

"We felt really lucky, blessed that we had coverage. Otherwise we wouldn't have been able to afford it," Jill Sauter said.

The cost for the treatment makes the latest ruling even more important to families dealing with the challenges of autism.

"This is a big relief for the autism community." said Jeannette Rivas from the Autism Society of Oregon, which she added "has been working on this for many years."

After the judge's decision, the Oregon Insurance Division ruled that insurers cannot broadly deny payment for ABA therapy, but they also said there are limited circumstances in which denial of coverage may be reasonable.

It said a bulletin will be issued later to clarify what those circumstances might look like.

For now, many more families will be able to send their child to ABA treatments.

"It will change their lives," Jill Sauter said. "It totally changed our lives and how I thought my future was going to be.".

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