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Saturday, March 11, 2017

Alabama Mandate Legislation

The Politics of Autism includes an extensive discussion of insurance.  At the Alabama Media Group, Trisha Powell Crain reports on Alabama mandate legislation.
A bill to require insurance coverage for therapy for children with autism faces an uncertain future after the House Insurance committee chair, Rep. Kerry Rich, R-Albertville, this week called for compromise.
But the problem is the two sides couldn't be farther apart. And Rich made no promises that he will bring the bill up for a vote.
HB284, sponsored by Rep. Jim Patterson, R-Meridianville, calls for health insurance coverage for applied behavioral analysis, a type of behavioral therapy that is a primary treatment for children with autism.

A competing version of the bill, SB57, calls for coverage of the therapy only for children from birth through nine years old and places the administration of the program under the Department of Mental Health. That version would also pulls $3 million from the state's education budget to provide no more than $40,000 of services per child in a given year.
Opponents of SB57 argued the financial burden doesn't belong in the education trust fund, nor should it be administered under a government agency.
According to Autism Speaks, 45 states cover behavioral therapy for people with autism. It is the primary therapy for children with autism and is as essential to treating autism as insulin is to treating people with diabetes.
Ashlie Walker, a board-certified behavior analyst, employs 24 certified behavioral analysts who work in Alabama, and calls the battle against HB284 "a war on kids with special needs."
Michael Wasmer with Autism Speaks said the cost to provide coverage was around 50 cents per member of the involved insurance pool. But Blue Cross and Blue Shield of Alabama lobbyist Robin Stone spoke in total costs of millions of dollars.
Wasmer said Stone's projections were faulty because they were based on the assumption of maximum usage of behavioral therapy, because not all children with autism need behavioral therapy, and those that do would not require maximum usage.
Even children with autism who need maximum therapy only need that level of usage for three to five years, Wasmer said.

Once a child with autism starts school, if a determination is made that behavioral therapy is necessary, schools shoulder the cost. Ultimately, that means taxpayers are paying for needed therapy that supporters of HB284 believe should be covered by insurance.