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Tuesday, February 8, 2011

Virginia Mandate Update

The News and Advance [Lynchburg, VA] reports:

A bill that would require insurance companies to provide coverage for autism survived three attempts to amend it Monday in the state Senate.

Sen. Steve Newman, R-Lynchburg, argued that SB1062 should be changed so that autism coverage would not be a mandated benefit.

Instead, Newman said, the bill should require insurance companies to offer the autism benefit to anyone who chooses to purchase it through their employer-sponsored health insurance plan.

Sen. Janet Howell, D-Fairfax County, said a package of amendments Newman proposed for the bill “may seem inoffensive, but it will render it a hollow shell.”

Howell argued that the autism bill already has a limited scope because it requires benefits only for children ages 2 through 6, and only for group-insurance plans in companies with more than 50 employees.

The Senate rejected the amendments on an unrecorded voice vote.

Sens. Frank Wagner, R-Virginia Beach, and John Watkins, R-Powhatan, also offered amendments that were rejected.

The Virginia House of Delegates included $410,000 in its budget released Sunday for a program that would require businesses to provide insurance coverage for children with autism.

Speaker Bill Howell (R), House Majority Leader Kirk Cox (R) and House Appropriations Committee staff directed the money be put in the budget even though Del. Lacey E. Putney (I-Bedford), chairman of the Appropriations Committee, was opposed.

And Putney, who voted against the autism bill Wednesday, said he was not told of the budget move beforehand.

"Do you think I know everything in the budget, honey?" he asked. "I don't know what's in a $78 billion budget...I don't know."

Howell supported the bill for the first time in a decade, upsetting some members of his caucus, who question supporting a new mandate while opposing the health care overhaul passed last year.

Del. Ben L. Cline (R-Rockbridge) proposed an amendment that would have required insurers to offer a package to businesses that included autism coverage but allowed businesses to choose not to buy it. The His amendment was defeated.

The Washington Post offers some important background on how the bill advanced:

In the beginning, several Northern Virginia families whose children have autism thought that their wrenching stories would be enough to get some help from their representatives in the General Assembly.

At town halls and rallies, through blogs and e-mails, the families conveyed the difficulty of coping with a mysterious ailment and the staggering cost of its treatment as they pleaded with lawmakers to impose mandates for insurance coverage.

But when that didn't work, the families took a new tack: They focused on the facts. They drilled lawmakers with detailed cost-benefit analyses to the state. They sometimes made explicit their threat of political action at the polls, while all along quietly working on House Speaker William J. Howell (R-Stafford), whose eventual support angered some members of his party.


"This bill is a huge step in the right direction for the state of Virginia," said Pat DiBari, president of the Virginia Autism Project, a nonprofit group that grew out of a Loudoun County summit on autism in August 2008.

Sen. Janet D. Howell (D-Fairfax), who sponsored the Senate's bill, chalked up this year's progress to "effective advocacy" that enlisted the House speaker as an ally.

"And the fact that it's an election year - it's hard to be against children and autism and their families," the senator said.


DiBari said he visited Howell multiple times in the speaker's private law offices. Champion said advocates followed Howell to town halls and other public appearances. They laid out for him the data from South Carolina, where a less restrictive autism bill costs the state about 84 cents per insurer per month and less than $1 million a year. And it didn't hurt that Howell was friendly with his counterpart in South Carolina's legislature.

Howell even received a telephone call from a former law school classmate at the University of Virginia: Bob Wright, the former chairman of NBC Universal who launched the foundation Autism Speaks after learning that one of his grandchildren had autism.

DiBari said he tried to understand Howell's position as much as he tried to convey his own. Howell was sympathetic but told DiBari that he and other advocates had to also have a grasp of the potential impact on the state budget and private businesses when the economy is still in poor shape.

In interviews, Howell said this year's bill strikes a balance between the business community and families of autistic children."I honestly can say that this was not a political consideration," Howell said. "It looked like something we could do to reach the core people that really need the help the most without having an undue burden on businesses."

The Richmond Times-Dispatch reports:

But not everyone's satisfied. Opponents, including the National Federation of Independent Business, the Virginia Chamber of Commerce and tea-party groups, say the law would be another costly health-care mandate on Virginia businesses and taxpayers.

And one of the bill's opponents, Del. Jackson H. Miller, R-Manassas, has asked Attorney General Ken Cuccinelli to determine if federal law allows the legislature to cap insurance coverage at $35,000.

At Greason's request, the House Appropriations Committee has proposed spending $1 million to cover the cost to the state, which a study by the legislature's watchdog agency, the Joint Legislative Audit and Review Commission, estimated at between $590,000 and $820,000 annually.

Americans for Prosperity, a conservative group with 80,000 members in Virginia, began making automated calls Jan. 31 opposing the bill.

"We're not selectively targeting this bill because of what it covers, we're targeting it because it's a mandate," said AFP State Director Ben Marchi. "At a time when Virginia families are cutting from their own budgets, the last thing we need to do is saddle them with increased health-care costs."

Marchi expressed bitter disappointment in Howell for his support of the bill, saying he had proved that "what liberal Democrats can't accomplish on their own, he will happily help them with."

"Frankly, I think the Republican caucus needs to look for new leadership," Marchi said.