Bill outlines common-sense autism treatment

Published 3:00 am Wednesday, April 5, 2017

A better autism treatment bill has been introduced in the House by Rep. Jack D. Williams, HB 404, for the Legislature to consider when it returns from spring break on Tuesday.

HB 404 would authorize the Department of Mental Health to administer an applied behavior analysis program that provides ABA intervention services to children from birth to age nine with autism. This bill would limit the amount of ABA intervention services to $40,000 annually and would appropriate $3 million from the Education Trust Fund to the Department of Mental Health to administer the ABA program. The State Department of Education and the Department of Early Childhood Education would be involved.

This bill virtually mirrors SB 57 by Sen. Gerald Allen that resulted from meetings beginning a year ago involving stakeholders concerned with autism issues, including the Business Council of Alabama. Last year when autism coverage first came up, the business community, medical stakeholders, autism advocates, and legislators began meeting to collect facts and discuss potential solutions.

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The BCA was engaged in every step of this informed public policy discussion and we attended and participated in every meeting of the group on how best to serve children with autism while at the same time not hampering employers and their ability to provide affordable health insurance. We are concerned about the unknown cost of HB 284 and will continue to be a part of meaningful discussions to find solutions.

Unfortunately, SB 57 was not given a fair hearing. Instead, HB 284 by Rep. Jim Patterson that had not been before the governor’s autism working group was forced to the forefront, dismissing months of our hard work.

HB 284 has no age restrictions, no limit to annual benefits, and allows virtually any treatment, all paid for by employers, private and public. It would affect all health plans, including 400,000 current and retired state employees, and more than 500 county and city government employee plans. However, it would not cover children on Medicaid or CHIPs, those who need it the most financially.

The bill’s fiscal note states that HB 284 as introduced will increase financial obligations of the Public Education Employee Health Insurance Board and the State Employee Insurance Board by an “undetermined amount … for the treatment for autism spectrum disorders without dollar limits… The actual amount of the increase is UNDETERMINED (emphasis added) at this time … ”

It is an unenviable position as the business community’s stance against health mandates is misconstrued as opposition to treatments or diseases. That is simply not true. But it certainly is easy and convenient to transform the business community’s opposition to open-ended government mandates with a broad brush of being against autistic children receiving therapy.

Since all insurance is self-funded and paid out-of-pocket, the public needs to know the cost to a their employer whether it’s a large manufacturer, a small mom-and-pop, a newspaper, or an already financially stressed government agency. If costs go up, the currently insured could lose benefits, see their premiums increase, or even lose insurance due an increase that may be the tipping point for some employers. Sound familiar?

We will continue to be part of meaningful discussions to find solutions. Our concern has always been the unknown cost of HB 284 that would require all health insurance policies offered in Alabama to cover prohibitively expensive autism therapies.

Children diagnosed with autism absolutely need access to care. That is what is important, not “insurance reform,” the catch-phrase being used in this discussion.

William J. Canary, president and CEO, Business Council of Alabama