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Measure moves to House
HONOLULU (March 7, 2014) -- The Hawai'i Senate voted 24-1 for SB.2054, an autism insurance reform bill, and sent the measure to the House. The first hearing is scheduled Wednesday before the House Health Committee.
Introduced by Senators Josh Green,Suzanne Chun Oakland and Russell Ruderman, the bill would require state-regulated health plans to coverthe screening, diagnosis and evidence-based treatment of autism up to age 21, including up to $50,000 for behavioral therapy. Lifetime benefits for behavioral health therapy, such as applied behavior analysis (ABA), would be capped at $300,000.
The bill is similar to a measure that passed both houses of the Legislature last year, but then failed to clear conference committee. In addition to Autism Speaks, the measure is supported by the Hawaii Medical Association, the Hawaii Disability Rights Center, and other groups.Opposition has been raised from theHawaii Medical Service Association and Hawaii Association of Health Plans.
In addition to behavioral health ABA treatment, the bill would require coverage for autism-related psychiatric, psychological, pharmaceutical and therapeutic care, such as speech, occupational and physical therapy.
Hawaii is one of 16remaining states yet to require state-regulated health plans to cover essential autism treatments and services.
Senate President Steinberg suggests possibility of funding Medi-Cal coverage
SACRAMENTO (March 5, 2014) --The leader of the California Senate has raised the possibility of funding coverage for applied behavior analysis (ABA) for autism through Medi-Cal, the state's Medicaid program.
Senate President pro Tem Darrell Steinberg raised theMedicaid funding issue at the conclusion of a hearingby the Senate Select Committee on Autism & Related Disorders on the effectiveness of SB.946, the state's 2011 autism insurance reform law.Steinberg, who authored the law, said the law on balance has been a "tremendous success."
"The next step, of course, is extending (applied behavior analysis) therapy to families who are on Medi-Cal," Steinberg said, according to California Healthline. "It's equal protection. If it's good for some kids, then why isn't it good for all kids?
"It's an issue of money, and we intend to take that up during the budget session," Steinberg said. "We ain't done yet. There's one more budget cycle."
Last year, the Legislature and Governor Jerry Brown failedto reach a funding agreement to continue autism therapies for 900,000 children who transitioned out of the Healthy Families Programinto Medi-Cal. The transition was supposed to have resulted in no loss of services, but instead many families said their children lost access to ABA once in Medi-Cal.
KXTV-10,Sacramento's ABA affiliate station, reported on the hearing:
Jon Owen with Utah Autism Coalition makes case for SB.57
SALT LAKE CITY (March3, 2014) -- The Salt Lake Tribune conducted a live webchat on two autism insurance bills before the Legislature featuring reporter Kirsten Stewart, Jon Owen, president of the Utah Autism Coalition, Rep. Ronda Menlove and Kelly Atkinson, executive director of the Utah Health Insurance Association.
Menlove is sponsoring HB.88, which would makea pilot state program that serves 300 children with autism permanent. Menlove has said the program would address about 10 percent of the state's need.
Owen said his group supports SB.57, sponsored by Sen. Brian Shiozawa, which would require state-regulated health insurers to cover medically necessary treatments for autism, including applied behavior analysis (ABA). Owen said the bill, which passed the Senate last week, would complement Menlove's initiative by enabling families with insurance to use those benefits rather than join in the competition for benefitsprovided through the pilot program.
State with highest autism prevalence in the nation moves step closer to requiring treatments
SALT LAKE CITY (February 28, 2014) -- The Utah Senate has approved SB.57,thefurthest an autism insurance reform bill has progressed in the state Legislature since efforts began in 2009. Utah has the highest prevalence of autism in the nation at 1 in 47, yet is one of of only 16 states not to require private insurers to cover medically necessary treatments.
The vote was 18-7.
"Autism Speaks commends Senator Brian Shiozawa [left] for his leadership in steering this urgently needed legislation through the Utah Senate," said Mike Wasmer, Autism Speaks' associate director of state government affairs. "We join with the Utah Autism Coalition and the state's autism community in urging the House to now do what's right and pass this bill."
Shiozawa's bill would require state-regulated health plansto coverspeech, occupational and physical therapy, psychological and psychiatric care, and behavioral health treatments, including applied behavior analysis (ABA).Behavioral health treatment benefits would be capped annually at $36,000 throughage 9 and $18,000 from ages 9 through 18.
During debate on the bill Thursday, Shiozawa said autism is "in epidemic proportions, the insurance companies themselves say that autism is in epidemic proportions in the state of Utah. They acknowledge that this is a real condition, they also acknowledge that there is a best therapy for this.
"We're asking that they simply cover this condition," Shiozawa said.By supporting the bill, Shiozawa told his colleagues, "You give the children and their families, the thousands of children in the state of Utah a voice, a voice to be heard by the insurance companies, a voice that says to them we faithfully pay our premiums, please cover our condition."
Shiozawa said he had attempted to craft a workable bill by working with two major Utah insurers.
"I have gone to their offices, I have sat down with them, I have offered that we will do whatever we need to do to negotiate on this, on dates of services, on the ages, on the caps," he said. "Make this your bill, this is your opportunity. And their response is, no, we're going to fight this and we're not going to pay for this."
Senator Scott Jenkins of Plain City spoke against the bill, calling it a form of socializing costs. "This is making it a mandate for the insurance companies to cover their insured," he complained.
However, Senator Todd Weiler from Woods Cross said the autism debate had changed his views on insurance after a constituent explained how his son with autism was initially denied coverage for a broken arm.
"The insurance company denied the bill using as an excuse the child had been diagnosed with autism and that the broken arm most likely was caused because the child was autistic," Weiler said."That is discrimination. And if that's how insurance companies are going to treat children in my district, that's going to change my opinion about insurance mandates."
Senator Deidre Henderson of Spanish Fork said the insurance lobby had indicated that the billing was later resolved after an investigation determined the original denial was the result of a "miscode." She voted against the legislation.
Senator Karen Mayne, a retired para-educator from West Valley City, said when she began her career, no more than one or two children in the school had autism."When I left we had just about one in every class...This is an epidemic, this is divorce city, this is crisis city and there is only so much energy in a family and it does more than harm the child, it harms the family, it harmssociety."