A deal struck after weeks of negotiations among House Republican leaders could extend coverage for treatment of about 800 children with autism, but would stop short of a more sweeping and contentious mandate.
"We believe this is a Utah solution to addressing autism," said House Assistant Majority Whip Ronda Menlove, R-Garland, who had sponsored the bill requiring about a third of Utah’s insurance carriers to cover autism treatment.
Under terms of the deal, which will be contained in HB272, the state would set up a two-year pilot program within the health plan that covers public employees, which would extend coverage to a few hundred children.
Rep. Jim Dunnigan, R-Taylorsville, an insurance agent who was part of the negotiations, said the state would put in about $2 million toward covering low-income children through Medicaid. That would be matched by about three times as much in federal funds to cover about 500 children.
Menlove said she wants more, and will pursue $6 million in each of the next two years, not including the federal match. "I’m going to shoot for the stars," she said.
Then, private commercial carriers, corporations and others have agreed to kick in about another $2 million to a state fund that would enable the treatment of few hundred others.
Children between ages 2 and 6 would qualify for the benefits.
"It will not help everyone universally," said House Majority Whip Greg Hughes, R-Draper. "But we’ve been told that early intervention is critical in terms of costs that come down the road."
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The bill is scheduled to be heard by a House committee Wednesday morning.
"It’s the right approach," said Rep. Jim Dunnigan, R-Taylorsville, an insurance agent who has been part of the negotiations. "I don’t support just a broad mandate on the commercial insurers, because when we do that, we only have the ability to reach out and control about a third of the market, and that’s the small employers."
That is because about two-thirds of Utahns either work for large corporations that self-insure or are on federal plans Medicare or Medicaid, which aren’t affected by state mandates, or have no insurance.
"We’re not going to be able to serve every child with autism in the state in this age range," said Menlove, but it would help gather information about what resources, treatments and funds are needed.
Researchers from the University of Utah and Utah State University would gather data to study the outcomes of the pilot.
"We want to walk away with a collaborative solution," Menlove said. "Autism is not going away."
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Utah House GOP reaches compromise on autism coverage