Lawmakers, led by Republican state Rep. John Rubin of Shawnee, have negotiated a deal with insurers that would extend autism coverage to about 250 children under 18 starting in 2015. Rubin’s agreement was introduced as a bill last week. Hearings on the measure are scheduled for this week.
• Rubin’s plan would provide yearly coverage for 520 hours of applied behavior analysis, or 10 hours a week. Advocates for children with autism pushed for more than 2,000 hours a year, or 40 hours a week.
Wasmer said 20 to 25 hours of treatment each week is generally considered a minimum with 40 hours prescribed in more severe cases.
• Rubin’s plan requires anyone who provides applied behavior analysis to be licensed by the state starting in 2016.
The insurance industry says it wants licensing to ensure quality care. But advocates for autistic children worry that establishing a licensing system might delay coverage and access to service. Missouri licenses the same type of therapists. Just 28 of Missouri’s 115 counties had licensed therapists as of Jan. 21.
• Rubin’s proposal applies initially to employers with more than 50 employees with health plans in place before the federal Affordable Care Act was enacted in 2010. The measure would extend to health plans for individuals and small employers in 2016, adding coverage for an estimated 500 more children.
Rubin said it was politically impossible to cover every child with autism — estimated at 8,400 in Kansas — because the federal Affordable Care Act requires the state to pay for any new mandate added to health plans sold under the law.