Senate Passes Mandated Autism Treatment Coverage
The Autism News | English
By BOB LEWIS, The Associated Press Political Writer
RICHMOND, Va.― Legislation that would compel insurers to pay for expensive but effective treatments for children with autism won overwhelming passage Tuesday in the state Senate despite opposition from mighty insurance and business lobbies.
On a 27-13 vote, Sen. Janet Howell’s bill advances to the House, where a companion measure died on a tie vote in a subcommittee two weeks earlier.
The bill would mandate coverage by certain employee health plans for applied behavior analysis, the treatment that psychiatric and medical officials say is the most effective and promising for children with autism. Insurers say ABA is an educational service, not a medical one that should be covered.
Howell’s bill restricts coverage to children from age 2 years through 6, and limits annual insurance outlays for ABA to $35,000. Because of the record $4 billion gap facing the next state budget, it exempts state employees from required coverage until 2015.
“This bill is so limited, and it breaks my heart it’s so limited,” Howell said. “But it’s a small step, a baby step, for children with autism spectrum disorder and their families.”
Autism Speaks, a national advocacy group for families of autistic children, contends that mandated ABA coverage in Virginia would increase the cost of health insurance premiums per insured by $10 to $25 a year, less than a 1 percent increase.
A 2008 study by the General Assembly’s Joint Legislative Audit and Review Commission said 7,509 children 20 or younger with autism received special education and related services in public schools as of December 2007. That’s a little more than half of the nearly 14,000 estimated cases of autism in Virginia.
Opponents, including Virginia’s health insurers, the Chamber of Commerce and the National Federation of Independent Businesses, contend mandated coverage would mean higher premiums, forcing employers to either drop insurance plans, lay off workers or even close.
While the bill faces tougher challenges in the strongly Republican House than the Democratic-controlled Senate, Tuesday’s victory was significant for supporters in a General Assembly known for its hostility toward spending mandates on businesses.
By only a 19-21 vote, the bill survived a floor amendment from Sen. Frank Wagner that would have marked the bill for death by adding state employees to those entitled to mandated ABA coverage. That would have required new spending in a budget already facing draconian cuts to public schools, health care and other traditional priorities.
“If we think it’s good enough for our private insurance plans in Virginia, then it ought to be good enough for our state employees,” Wagner said, saying businesses were struggling no less than state government.
Sen. Walter A. Stosch, R-Henrico, whose suburban Richmond district is rich with state employees, agreed.
“I happen to have experience in my family with autism. I am very familiar with the impact that autism has on families, but to say that we cannot cover state employees because of the fiscal constraints is almost ridiculous,” said Stosch, an accountant and a member of the budget-writing Finance Committee.
Howell appealed to colleagues to reject the amendment and “not let the perfect be the enemy of the good.”
During the debate, Lavada Robertson of Franklin County and Amy Trail of Vinton, mothers of autistic children, watched from the Senate gallery and wept silently. While Howell’s bill comes too late to help their children, “I don’t want any other moms to have to go through what we have,” Trail said.
On the Web: Legislative Information System: Bill SB464
Source: http://wjz.com/wireapnewsva/Mandated.insurance.coverage.2.1498566.html
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