Utah autism insurance mandate expanded!

On March 26, 2019 Governor Gary Herbert signed Senate Bill 95 into law, which expands Utah’s autism insurance mandate.  

The new law eliminates existing age and hour caps for coverage of autism spectrum disorder, expanding access to transition-age youth and adults with autism! 

Utah passed its original autism insurance mandate in 2014, requiring coverage for the diagnosis and treatment of autism spectrum disorder under state-regulated, individual and large group plans. However, this coverage was limited to children ages 2-10 years old. Coverage for behavioral health treatments, including applied behavior analysis (ABA), was also limited to 600 hours per year (approximately 11.5 hours per week).  

Thanks to the support of the Utah state legislature and Governor, these restrictions in coverage for autism have been removed.

Effective January 1, 2020, individuals of any age will be covered under state-regulated individual and large group plans. Furthermore, the amended mandate will prohibit these health benefit plans from limiting hours of treatment for autism. The law also removes a provision that allows the state insurance commissioner to waive the requirement that a health benefit plan cover the diagnosis and treatment of autism if claims for autism coverage caused premiums to increase in excess of 1%.

We are grateful for the support of the legislative champions and local advocates that helped achieve this milestone!

Access to meaningful and medically necessary care for autism can change the trajectory of a person’s life. Autism Speaks is committed to improving coverage for autism throughout the country, for people across the spectrum and throughout the lifespan.