AAoM appreciates the frustration of families at the announcement of a depleted state autism reimbursement fund. The Autism Alliance of Michigan led the charge toward Insurance Legislation in 2012 and the subsequent Medicaid Bill. Unfortunately for many families, the autism law in Michigan is a STATE law, affecting only companies regulated by state law. The majority of companies in Michigan are governed under federal law (ERISA; a.k.a. self-funded), so those employers were never required to add autism benefits for their employees.
At the time we passed the state laws, Michigan became the only state to step out and pay for autism claims…and not just for state regulated plans. The fund that was created was also open to self-funded companies, as well, to encourage them to add autism coverage without having to pay for it. NO OTHER STATE has created such a fund. In fact, most self-funded companies who add autism coverage do so knowing it will cost them.
We have been lucky to have benefited from this reimbursement fund. Michigan has more companies adding coverage than any other state, largely due to the fund reimbursements. We have more children accessing services than ever before. We MUST continue the progress we’ve made and WE WILL NEED YOUR HELP!
Without the incentive of a fund to pay company claims, many will choose to either reduce or eliminate the benefit or not add it in the first place.
We are currently putting together a plan of action to appeal to legislators to allocate replacement funds, and will look to our base of families and autism service providers to help in those efforts. As it is open enrollment time, we also encourage any families who do not have employer-provided autism benefits to contact MiNavigator at navigator@aaomi.org to get in contact with our Insurance Specialist who can walk you through the process and resources for purchasing an Individual Policy to cover autism services, including ABA therapy.