Rep. Scott Munsterman’s bill sought to require some health care plans to cover ABA therapy and other autism treatments. From 60,000 to 90,000 citizens would be affected — primarily those who get their coverage from larger employers, and those with smaller plans that have been grandfathered in under the federal Affordable Care Act. Small business insurance plans and nongrandfathered plans on the marketplace would not be affected.
Munsterman originally proposed requiring all plans to cover ABA therapy. But under the Affordable Care Act, states that impose new coverage mandates on insurance companies are required to pay for that cost. To dodge a budget battle and weaken opposition from Gov. Dennis Daugaard, Munsterman narrowed the bill to apply only to those plans the state wouldn’t have to pay for.
But insurance companies said they shouldn’t have to pay for such expensive treatment, which they said would force them to pass costs on to customers in the form of higher premiums.
Wellmark previously estimated it might cost as much as $7 per member per year more to cover ABA treatment.
The Senate Commerce and Energy Committee voted 5-2 to kill the bill, with Sens. Ryan Maher and Angie Buhl O’Donnell opposed.
But supporters aren’t giving up. Munsterman is looking at ways to bypass the Senate committee, which could include sticking the autism language into another bill. That showdown probably will come on Monday.