Lawmakers weigh fate of autism treatment bill

By JENNIFER KIRBY
Community News Service
UM School of Journalism

Parents of children with autism are awaiting a key decision this week on legislation that would require insurance companies to cover a range of treatments for autism that have been shown to improve a child’s quality of life.

Senate Bill 234, sponsored by Sen. Kim Gillan, D-Billings, awaits action by the Senate Finance and Claims Committee. Given the economy and falling state revenues, any bill with costs attached faces long odds, the bill’s sponsor said last week.

“It’s is going to be very tough to get it out of the committee,” Gillan said.

But in a hearing last week, Gillan stressed that working parents with insurance face high out-of -pocket costs to provide their autistic children with the treatment they need because insurance companies have been denying coverage of these recommended treatments.

Supporters of the bill delivered emotional testimony, emphasizing the cost of not treating a child with autism. They testified that the treatments addressed by this bill will save the state money in the long run, because children that receive early, intensive therapy are less likely to need special education services in school and state mental health services as adults.

But insurers warned that mandates for additional coverage mean higher costs that may cause more people to go without insurance. Frank Cote of Blue Cross and Blue Shield said that every time a mandate is passed, .25 percent of those insured drop their coverage because the increase in premiums is too much of a financial burden.

Estimates of what those costs would be ranged widely. Money to cover increased costs to state and university systems insurance plans could come either from additional appropriations or higher premiums passed on to state employees.

The budget office calculated that $1,375,466 in additional funding would be necessary to cover the cost of health coverage for state workers. State employees could see an increase $12.56 per month, if the costs are passed on to them.

But Gillan said those numbers are too high. Oliver Wyman Actuarial Consulting, Inc., an independent actuarial firm, calculated the cost of the increased benefits to be $12.70 per year, not per month.

Amendments to the bill have cut costs significantly by limiting coverage to children 18 years or younger and reducing the maximum benefit for older children because the treatments available focus on early intervention and are not as effective in children over eight years.

Coverage for services to maintain functioning of children with an autism spectrum disorder was eliminated, as was coverage for dietitian services.