Allergy News: State to Require Insurance Coverage of Epis; Elijah’s Law Progress

By:
in Food Allergy, News
Published: April 26, 2021

Delaware to Mandate Auto-injector Coverage

A bill headed to Delaware Governor John Carney’s desk would require insurance plans to cover epinephrine auto-injectors for children. That will make Delaware the second state to require insurance coverage of epinephrine auto-injectors for children and teens.

Both chambers of the Delaware state legislature have passed House Bill 95. It requires both private and state insurance plans to “provide coverage for medically necessary epinephrine auto-injectors for individuals who are 18 years of age or under by including at least one formulation of epinephrine auto-injectors on the lowest tier of the drug formulary developed and maintained by the carrier.”

Rep. Kimberly Williams

This means that for those with private or state-issued insurance (including Medicaid), at least one brand of auto-injector would be covered.

Rep. Kimberly Williams, the bill’s sponsor, told Allergic Living that she read about a similar law in Illinois and decided that Delaware needed to ensure that lifesaving medication was available to those who need it. Most plans do cover epinephrine to her knowledge, but she wants to codify the coverage explicitly, to ensure insurance coverage and prevent any efforts to exclude it.

Williams does not have a family member with food allergies, but says: “I can’t imagine what families go through, worried that someone can give their child a food that could hurt them.” As epinephrine is critical medication, “it should be affordable.”

Self-insured plans are not included in this bill, nor does it address high deductibles, co-pays or prescriptions for adults. But Williams is willing to work on expanding the bill in the future. “Sometimes you have to start out small, get people to listen and to appreciate what you are trying to change. When you start smaller, you are able to add to it down the road. It is easier to manage and get people to buy in and get one part of it.“ –Jen Jobrack

Elijah’s Law Headway in 2 States

In March 2021, Allergic Living reported that Illinois had introduced an Elijah’s Law bill. On April 22, the Illinois House voted unanimously in favor of the bill. Officially called the Childhood Anaphylactic Policy Act (HB 102), this legislation would require the state health department, in consultation with the board of education, to establish anaphylaxis policies and procedures for school districts and daycare settings.

Representative Jonathan Carroll, the bill’s sponsor, says the bill would add daycare centers to existing school food allergy policies currently required in Illinois, and tighten anaphylaxis training across school levels. The bill has now headed to the state Senate for consideration.

Thomas Silvera and his wife Dina Hawthorne-Silvera are championing the expansion of Elijah’s Law, named for their son Elijah-Alavi Silvera. The first such law passed in their home state of New York in 2019. Elijah was only 3 years old when he was fed a grilled cheese sandwich at his preschool and tragically died of an anaphylactic reaction. The center had documentation on his food allergies and asthma.

On hearing of the Illinois vote, Silvera told Facebook followers: “I’m in tears now because I know this bill will help and protect so many young children. Now, let’s get those Senate votes in.”

And there is more promising news for parents of kids with food allergies in daycare. An Elijah’s Law bill (HB 1259) was recently introduced in the Pennsylvania legislature. As with the Illinois bill, this bill contains language to on prevention, emergency treatment and stresses requirements for staff anaphylaxis training. Representative Ryan Warner, whose own son has a life-threatening food allergy, is the sponsor of that bill.

Through their Elijah-Alavi Foundation, the Silveras are working with local food allergy advocates to expand Elijah’s Law into many more states. –Gwen Smith

Related Resources:
All About Epinephrine Injectors: From When to Use to Getting It Hot, Cold or Wet
Elijah’s Law Protecting Food Allergy Kids is Official in New York State
Talking Food Allergy Podcast with Thomas and Dina Silvera