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Autism insurance bill gets final legislative passage

Montgomery Advertiser - 5/18/2017

May 18--The road wasn't smooth, but a bill that would require insurers to cover autism therapies in most situations has the Alabama Legislature's approval.

The Alabama House of Representatives voted 103 to 0 early Thursday morning for a an amended version of legislation that would require insurers to provide the therapies for children 18 and younger. The final version was somewhat less than what supporters initially sought, and includes an exemption from the mandate for businesses that employ 50 people or less.

But Rep. Jim Patterson, R-Merdianville, the bill's sponsor, said after the 2:08 a.m. vote Thursday that it was an important first step in allowing families with autistic children access to critical treatment.

"It's hard to be against children who need help," he said. "103 votes, that's pretty strong."

The bill goes to Gov. Kay Ivey.

Alabama is one of a handful of states that does not require coverage of autism therapies. Parents can pay out of pocket for the treatments, which can cost up to $120 an hour, and the state's public schools find themselves paying for them when private insurance does not. Supporters of the legislation said requiring insurance coverage of the treatment would allow children to get therapies at earlier ages, where it could make long-lasting impacts. Patterson said having the coverage available would better prepare children for schools and allow self-sufficient children to become more "self-sufficient."

"I really believe in the long run this will save money, not cost money," he said.

The bill passed the Alabama House of Representatives 100 to 0 last month, but hit turbulence once it reached the Senate. The Senate did not report the bill to a committee for a week. When it finally reached the Senate Finance and Taxation General Fund committee, chairman Trip Pittman, R-Montrose, tried to amend it several times, then threatened to hold the legislation back out of concern for costs it might impose on the state's public insurance programs, including the Public Education Employees Health Insurance Program (PEEHIP); the State Employees Health Insurance Program (SEHIP), Medicaid and AllKids.

The bill also faced opposition from Blue Cross Blue Shield of Alabama, the state's dominant insurer, which said the cost of coverage would be too expensive. The Business Council also criticized the bill and called it an "Obamacare-Style tax hike" after it passed the Senate Tuesday.

Supporters of the bill accused Pittman of trying to delay the legislation, and some senators threatened to slow the Senate down if a vote was not taken. A compromise version delayed the implementation of the mandate for PEEHIP, SEHIP, Medicaid and AllKids for a year, and included the exemption for firms with 50 employees or less. A provision to limit the coverage mandate to those 18 and younger was later added on the floor over the objections of supporters, but the bill passed the Senate 33 to 1.

Those changes drew some criticism on the House floor early Thursday morning.

"We're going to help the fewest we can help, because it costs too much," said Rep. Thomas Jackson, D-Thomasville.

Rep. Merika Coleman, D-Pleasant Grove, said she would vote for the bill because it "truly helps" those in need, but also raised objections to the changes in the bill, particularly the age limits. Patterson agreed with Coleman, saying "this is a starting point. This is not the end."

Patterson said after the vote that if Ivey signs the bill, he wanted to work with her to address reporting requirements taken out of the final bill and work to ensure smaller employers can offer the coverage. He also said passage of the bill -- helped by public pressure -- could serve as a civics lesson.

"It ought to show the public their lobbying counts a lot," he said. "What I'm hearing from my district is this is a popular thing. You can have an effect."

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