Debate over autism reform bill

BIRMINGHAM, Ala. (WIAT — The Autism Society of Alabama say Alabama is one of four states that still does not mandate insurance coverage for autism spectrum therapies. A bill making its way through the state house could change that.

House Bill 284 would require insurance coverage for applied behavior analysis (ABA) therapy.

This is something the Hall family hopes becomes a reality. They’ve been paying out of pocket for their son Liam’s therapy for autism. He was nonverbal. But, his parents say he’s come a long way from multiple therapies like speech, behavioral and occupational therapy.

The Halls say they pay at the low end about one thousand dollars a month. That’s just not in the budget for many.

Some of the push back against this bill comes from fears of rising premiums.

Here is a statement from Blue Cross Blue Shield of Alabama:

“Blue Cross and Blue Shield of Alabama currently provides coverage for treatments for children diagnosed with autism including: pharmacy care; pediatric services; psychiatric care and psychological care; along with enriched speech, physical and occupational therapies.  Children diagnosed with autism also receive the same robust benefits offered to any other covered child.  Some of our employer benefit plans also cover applied behavioral analysis (ABA) therapy.  However there are currently no ABA therapists practicing in Alabama who are licensed to provide the treatment.

Blue Cross opposes mandated benefit legislation that increases annual healthcare costs, impacts premiums and raises deductibles and copays for employers and individual members.  Mandated benefits remove the choice employers have each year to include the benefits most needed by their workforce.

Proposed bill, HB 284, would be the most liberal in the nation in terms of autism benefits. The bill would require additional benefits for the coverage of autism across Alabama, affecting individual and family plans,  small and large employer plans, and large publicly funded plans such as the State Employees’ Health Insurance Plan (SEIB) and the Public Education Employees’ Health Insurance Plan (PEEHIP), and more than 500 plans covering county and city governments. The bill imposes autism benefits requirements that are completely open-ended with no limitation on annual benefits or restrictions on age.

Employers and individuals would have to pay for these benefits even if they have no interest or need for the treatment.  The addition of autism mandated benefits to PEEHIP and SEIB are estimated to cost Alabama taxpayers over $22 million annually.  Over 500 Alabama counties, cities and local boards and authorities would also be required to add this benefit, costing additional taxpayer dollars.

Alabama employers already have the option to add autism benefits each year when renewing their coverage.  The Alabama Legislature approved this choice in 2012 by the unanimous passage of SB 283, the “Riley Ward Act”.   The Act was supported by the Autism Society of Alabama and made Alabama the only state in the nation to require that all insurers offer autism spectrum disorder treatment to its large group customers. The “Riley Ward Act” also resulted in the definition of covered benefits for autistic children, recognized Autism Spectrum Disorder as a disease and resulted in greatly expanded therapy coverage for autistic children.  “



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