Senate leaders promise vote on autism insurance bill

May 11--After a strange series of sieges and counterattacks, Senate leadership Thursday said they would get a bill requiring insurers to cover autism therapies to the full chamber, and planned a vote next week.

The announcement came after an emotional Wednesday evening, when Senate Finance and Taxation General Fund chairman Trip Pittman, R-Montrose suggested he would block the bill, and supporters responded with a threat to end the session.

Senate President Pro Tem Del Marsh, R-Anniston, said the bill would come out early this afternoon and would go to the floor for a vote Wednesday.

"I truly believe an autism bill will pass this body and go on to the governor," Marsh said before the Senate convened Thursday. "I do think it will be a good piece of legislation."

The scope of that legislation remains an open question. Pittman Thursday indicated he still wanted changes to the bill that he said would save the state's troubled General Fund money but could also pull back the coverage offered.

"I care about all these children," Pittman said. "But it's hard when you have to do something and pay for it."

The bill, sponsored by Rep. Jim Patterson, R-Meridianville, passed the Alabama House of Representatives 100 to 0 last month. In that form, the legislation required coverage of autism therapies -- which can run up to $120 an hour -- with coverage limits set on a sliding scale of age. For children nine and younger, insurers would cover up to $40,000 a year; for those 10 to 13, $30,000 a year; 14 to 18, $20,000 a year and $10,000 a year for those 19 and older.

But the legislation has had a much rockier time in the Senate. Leaders allowed the bill to languish for a week before assigning it to Pittman's committee. Blue Cross Blue Shield of Alabama opposed the bill, saying it would impose costs on employers, but said they would offer the coverage without a mandate. The committee passed the bill 14 to 2 but only after Pittman unloaded a quiver of amendments at it. Two found their targets: One excluded businesses employing 50 people or less from offering the insurance and another cutting benefits off at 16 years of age.

Supporters of the bill didn't care for the amendments but seemed at least willing to open to them. But in a peculiar move, Pittman refused to report the legislation out, saying he wanted language that would exempt the state's public insurers -- Medicaid; the Public Education Employee Health Insurance Program (PEEHIP) and the State Employees Health Insurance Program (SEHIP) -- from offering the coverage, saying he worried about costs to the program. The federal government requires Medicaid to provide services.

Don Yancey, deputy director for the Retirement Systems of Alabama, which oversees PEEHIP, said Thursday they estimated the therapies would cost about $18 million a year. That would be about 1.2 percent of the total PEEHIP budget, which runs close to $1.5 billion.

"In the grand scheme of things, $15 or $20 million is not a huge amount," he said. "But when you have to ask it from the Legislature -- I've been yelled at for asking for a lot less."

Pittman's maneuver stunned supporters of the bill, who accused the senator of breaking a promise to allow a vote. They warned that they would slow business in the upper chamber, or even move to end the session. Sen. Dick Brewbaker, R-Pike Road, who warned of a significant slowdown or shutdown of Senate business without a vote, said if committee chairs withhold bills, it's usually because of technical legal issues, and not because the chair lost a vote.

"I've never held a bill when we're almost at the end of the session and we're losing legislative days," he said.

Pittman said he wanted to be deliberative.

"You're trying to cool the cup of coffee and the cup of tea," he said. "This has a lot of momentum. A lot of it is justified and a lot of it is emotional."

Marsh said he expected further negotiations over the bill before the floor vote next week. He denied allegations of backrooms deals over the bill taking place.

"This talk about us creating a game and not getting a bill to the floor for a vote is ridiculous," he said. "We know how serious this is. We want to take care of this issue."

Brewbaker Thursday morning took a wait and see approach, though he said he felt confident the bill would get out.

"If everybody does what they say they're going to do, we're going to have a good day," he said. "If they don't, this may be the last day."

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