Last week, however, the state Insurance Department announced the lifting of the age limit on the treatment by three state insurers, including Blue Cross, which includes the Balfours. This means that anyone who is eligible for the treatment will be covered. Balfour stated, “I wept when I heard it.” It’s life-changing. The quality of our family’s life has improved greatly since Michael started therapy. Balfour stated that Michael used to wander off before therapy began, which is a common trait in autism children called elopement. Also, he had sensory overload. In the two years that he has been receiving therapy, all of this has stopped. Linda Balfour estimates that if the insurance companies, which include Magnolia, UnitedHealth, and Blue Cross Blue Shield, had not lifted the cap, she would have to pay $2,500-$3,000 out of pocket for the roughly 10 hours of weekly therapy Michael receives. Balfour stated, “But we would’ve done it.” Balfour said that “you do what you need to do.” Michael looked up at his mother and said “And then we wouldn’t have any money.” The program has significant out-of-pocket costs, but the cost to insurers is minimal according to Mike Chaney, Insurance Commissioner, and Secretary of State Delbert Hosemann, who worked with insurers to lift the age limit on ABA therapy. According to Blue Cross Blue Shield, the cost for insurers in South Carolina, with a population roughly equal to Mississippi’s, was 43 cents per month. Chaney stated that “We just said you’re going do it” or that legislation would tell you to do so. “It’s right for them to do it.” Previous bills to lift the age cap were stalled before reaching the governor’s desk. One of these bills was sponsored by Sen. Rita Parks (R-Corinth), in 2015. Parks stated, “I’m proud of the voluntary collaboration with us by our corporate partners to level the playing fields.” “…Thirty nine states offer (ABA coverage above Mississippi). This is unacceptable, and we are changing it today.” Prior to the cap being lifted, 45 states offered ABA coverage that was more than what Mississippi insurance provided for their beneficiaries. Lorri Unumb, of Autism Speaks, said that she was in Idaho Capitol last week to lobby legislators for ABA therapy. “And one (the legislators), said, “Now wait a moment. “Does Mississippi offer this therapy?” And I was able answer, “Yes, Mississippi has passed this legislation. You can’t believe what they’re doing for autism in Mississippi.” Other initiatives aimed to increase access to ABA therapy include pilot programs that train therapists at Holmes Community College and the University of Southern Mississippi. Michael Balfour was diagnosed in 2015. However, he didn’t start therapy for over a year until August 2016. His mother explained that Michael Balfour was diagnosed in 2015, but he didn’t start therapy for more than a year until August 2016. There are currently 42 behavioral analysts in Mississippi, and seven more will be added next week. Jim Moore, chair of the Mississippi Autism Board, said that the cap was “woefully inadequate” and showed the program changes needed. The cap technically remains in effect, even though the three largest insurers of Mississippi have agreed to lift it. This is because the state code still applies. Legislation is likely to be required in order to lift it across the state and require all insurers comply. Hosemann stated that this was a major step for the state.
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