Straight talk on health reform

Georgia Health News will answers your questions about how health care reform would impact a particular person or situation.

Q: How will the Affordable Care Act affect my special-needs child, who has autism? From S, Atlanta

A: Autism isn’t mentioned in the 2,000-plus page Affordable Care Act.

The advocacy group Autism Speaks, though, points out that the ‘’essential health benefits package’’ that would be administered under reform requires coverage for ‘’behavioral health treatment.’’ Those behavioral benefits haven’t been defined yet, but Stuart Spielman of Autism Speaks says he hopes it would include applied behavior analysis and other therapies for children with autism.

The benefits requirement would apply to the millions of people buying insurance through the health insurance exchanges that would begin in 2014, if the Affordable Care Act withstands attempts to gut or repeal it. The benefits package would not apply to large, self-insured employer plans.

There are Affordable Care Act provisions that indirectly would help families’ coverage for autism, Spielman says. They include:

  • Prohibiting insurers from excluding coverage based on pre-existing conditions for children – and eventually for adults.
  • Preventing insurers from dropping people’s coverage without cause.
  • Barring insurers in 2014 from charging people different premiums based on their health statusEliminating lifetime caps on benefits, and putting new restrictions on annual limits on coverage

If you have a question about how the health care reform law would affect you, your family, employer or business, please send your query to amiller@georgiahealthcarenews.com, and we’ll get help from experts to answer it.