Committee Chairman Tim Golden, R-Valdosta, the lead sponsor on SB 397, said the costs of the treatment that would be covered under the legislation could not exceed $35,000 per year for each child. The eligible age for coverage would be capped at 6 years old.
In addition, employers could opt out of the coverage for “applied behavior analysis” if it led to a 1 percent annual increase in premiums. Companies with 10 or fewer employees would be exempt from the mandate. It also would not apply to larger employers that self-insure their benefits.
Legislative efforts to require insurers to cover applied behavioral therapy for autism have been ongoing in Georgia for five years, led by Sen. Tommie Williams, R-Lyons, whose niece’s daughter was successfully treated with the therapy.
Lt. Gov. Casey Cagle joined Williams and Golden on Thursday in making impassioned pleas for approval of the SB 397. The bill now goes to the Senate Rules Committee before heading to the Senate floor.
Also voting in favor of the legislation was Sen. Charlie Bethel, R-Dalton, who serves as Gov. Nathan Deal’s floor leader. Bethel was among committee members who noted that Deal supported funding for the autism therapy by allocating $2.4 million in his FY 2015 budget for coverage in the State Health Benefit Plan.
SB 397 would not mandate payment for applied behavioral therapy under Medicaid and PeachCare, the programs covering children of the state’s poorest families.
The Georgia Association of Health Plans, an industry trade group, opposes the effort to require autism coverage, saying it would unfairly increase costs for employers.