February 17, 2012 · The House finance committee considered an amendment for House Bill 4260, which determines insurance coverage for autism spectrum disorders.
Kanawha County Democrat Mark Hunt has a child with autism. He’s a cosponsor on the bill. Hunt said he just wants to see the bill through.
“This bill is not so much for my child; this bill is more for other people’s children,” Hunt said. “Knowing that early intervention does make an extreme difference, I feel like we’re fiddling while children are actually burning out there. Every year we delay the full implementation of this bill, a whole generation of children is being lost.”
The bill provides $30,000 a year for behavioral therapy for three years before dropping down to $2,000 a month. Finance committee counsel Jennelle Jones says the bill clarifies exactly what that $30,000 should cover.
“The problem was when it left the House the $30,000 cap applied to ABA therapy,” Jones told lawmakers. “Then, the Senate amended in language that said the $30,000 cap applied to all treatment for autism which could include a drug regimen or other types of treatment that would be different from ABA therapy.”
The fiscal note for the bill was produced by PEIA and ranges from $12-22 million. Jones said the note doesn’t change from last year’s version. However, she said this year’s version does create consistency in the code.
“It makes the $2,000 cap applicable to only ABA as opposed to all treatment,” Jones said. “The green bill did that for the $30,000 cap, but then that left the code inconsistent between the $30,000 cap and the $2,000 a month cap. The committee substitute makes it consistent that any cap applies to ABA therapy as opposed to all treatment.”
Finance committee Vice-Chair Tom Campbell said the bill’s topic makes it rather taxing.
“It’s such a complex disorder that can lead to so many complications, particularly among children,” Campbell said.
“We want to deal with it and help our insurance providers and everybody deal with it, but we’ve got to struggle with the financial responsibility. While we’d love to solve every problem out there for everything, we have limited resources.”
The bill states that a child must be diagnosed with an autism spectrum disorder by age 8 for the coverage to take effect. Wayne County Democrat Doug Reynolds said that’s too young and tried to change it with an amendment.
“I can’t think of anywhere else in the code where we take some benefit and restrict it based on the diagnosis of a child. I don’t think there’d be a large fiscal note,” Reynolds told lawmakers.
“Most people know their child has autism before age 8, but in cases where it’s mild, it makes no sense to me why we’d have a bar at age 8. Even if there is somewhat of a fiscal note, if the difference is $2,000-$3,000, those are probably the kids that need the help the most.”
Campbell offered rebuttal.
“My fear is though in doing that that we endanger the coverage we’re already covering because of the large price tag,” Campbell said.
“The committee last year worked diligently with other states and state agencies to cover as many children as we could in a responsible manner. I think this bill does that. All we’re trying to do today is to correct an error that sometimes occurs late in sessions when bills don’t pass exactly as we think they have passed. I’m afraid if we adopt the gentleman’s amendment we’re going to go beyond and actually if we lose this bill we will restrict coverage.”
Ultimately, the amendment failed by voice vote.
The bill’s lead sponsor Barbara Fleischauer said what matter most are those affected by the disorders.
“It’s financially important, but it’s also important for those children that are going to have their development stunted or slowed and will be inside themselves,” Fleischauer said. “We want these kids to be fully participating adults. That’s what can happen if you get this early intensive education.”
While Reynolds’ amendment failed, the finance committee passed the bill unanimously. It now goes to the House floor.
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House finance weighs autism bill