by Dave Ranney, KHI News Service
Topeka — A House-approved bill that would require state-regulated health insurers to cover the diagnosis and treatment of autism sailed through the Senate on Wednesday.
House Bill 2744, which passed 38-2, now goes to the governor.
“We’re very excited that it’s passed,” said Michael Wasmer, a spokesperson for the advocacy group Autism Speaks. “It’s not perfect. There are some flaws, but it’s clearly a step in the right direction.”
If enacted, the legislation is expected to benefit about 750 children over the next two to three years.
“That’s about 20 percent of the children who aren’t covered now,” Wasmer said.
HB 2744 would require state-regulated insurers to cover a type of therapy known as “applied behavior analysis” for up to 25 hours a week for autistic children diagnosed between birth and age 5.
The treatments would be covered for four years, meaning that a child diagnosed at 2 would have access to up to 25 hours of the therapy a week until reaching age 6; a child diagnosed at 4 would have access until age 8.
After the four years, coverage for the therapy could be limited to 10 hours per week.
Children diagnosed after age 6 would be eligible for 10 hours per week. The coverage could end when the child turns 12.
Advocates for families with autistic children have argued that 10 hours per week wouldn’t be enough and that 25 hours should be considered the bare minimum. Forty or more hours, they said, might be needed by severely autistic children.
“What’s in the bill is not what we want,” said Jennifer Smith, executive director with the advocacy group Autism Society of the Heartland. “It’s not ideal. But we’ve been at this for six years now, and it’s become pretty clear that this is all we’re going to get this year. So it’s a step. We’ll take it and come back next year.”
The state’s insurance lobby has long argued against having to cover autism, calling the initiative a “mandate” that would increase costs and force companies to increase premiums. It also has argued that autism is a developmental condition rather than a medical condition.
Several senators spoke in favor of the bill Wednesday.
“Autism is like cancer in that if you detect it and treat it early, you’re much more likely to have a much better result,” said Sen. Steve Abrams, an Arkansas City Republican and a former chair of the Kansas State Board of Education. “I do support this bill.”
“I will be voting yes for this bill because it is a start,” said Sen. Tom Hawk, a Democrat from Manhattan. “I want us to move forward. I want to work hard to fix the things in this bill that need to be corrected.”
Hawk shared that his 4-year-old niece was diagnosed with autism when she was 18 months old.
“I’ve seen what families of autistic children go through,” Hawk said. “With this bill, I want to provide my niece with the four years of treatment that she so desperately needs and that others like her so desperately need.”
The coverage requirements in HB 2744 would affect state-regulated, large group plans, starting Jan. 1. A year later, the mandate would be expanded to include state-regulated small-group and individual plans in place prior to the March 23, 2010, enactment of the Affordable Care Act, also known as Obamacare.
The senators who voted against HB 2744 were Sen. Mary Pilcher-Cook, Shawnee, and Sen. Caryn Tyson, Parker. Both are Republicans.
Sen. Rob Olson, an Olathe Republican and chair of the Senate Financial Institutions and Insurance Committee, assured the chamber that he will introduce a “trailer bill” to resolve some “technical issues” involving how autism would be defined and how treatment providers would be licensed.
The provisions in HB 2744 will not affect the large-group, self-insured plans in Kansas. Several of these employers’ plans – including Cerner, Garmin, Koch Industries and Children’s Mercy Hospital – already cover autism.
Kansas state employees’ health plan and Tricare, the U.S. military’s health insurance plan, also cover autism.
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