House committee looks for compromise with Senate autism bill
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House committee looks for compromise with Senate autism bill

Date: April 6, 2010
By: Kiki Schmitz
State Capitol Bureau
Links: HB 1311 SB618

JEFFERSON CITY - Insurance agency representatives asked a House committee Tuesday to reject the Senate version of autism insurance legislation. 

The House and the Senate have passed separate bills mandating insurance coverage for applied behavioral analysis therapy to treat autism spectrum disorders. A cost difference divides the two bills, with the House setting a $36,000 annual cap for treatment while the Senate bill would cap treatment at $55,000.

The two bills also differ on an age limit for coverage, with the House bill requiring coverage until age 18 and the Senate until 21. Additionally, the House bill establishes licensure requirements for therapists, while the Senate version does not.

The insurance industry representatives made their arguments before the House Health Insurance Committee hearing the Senate-passed version.

The sponsor of the original Senate bill, Sen. Scott Rupp, R-St. Charles County, offered a compromise between the two chambers' versions -- taking the lower age cap of the House and splitting the difference on the annual cap with a $40,000 limit per year.

Steven Bledsoe, Vice President of Government Affairs for Blue Cross and Blue Shield of Kansas City, spoke against the Senate bill. He said while he preferred the House version, their 18 and under age restriction was "excessive."

"Frankly, the age should stop probably at about 12," Bledsoe said. "Having said that, $36,000 is more appropriate than $51,000, and 18, though we think it's higher than it should be, is more appropriate than 21."

David Smith, a lobbyist for Anthem Blue Cross and Blue Shield, also opposed the Senate bill and expressed concerns about its lack of licensing requirements for therapists.

"There needs to be a background check, at least," Smith said. "These people are part of the day to day operation in the lives of those kids."

Insurance representatives have warned that mandating autism coverage would increase health insurance premiums for many Missourians.  Officials for one of the major health care plans covering state government workers estimate the Senate's version of the autism requirement would add an additional $1.7 million per year in costs

Qualms regarding licensing and training regulations resurfaced later in the hearing, when the government affairs director for the insurance company Coventry Health Care, Cheryl Dillard, testified against the bill.

"Many of [the therapists] will be alone with very vulnerable children," Dillard said. "Licensing is terribly important."

Witnesses testifying in favor of the bill included two mothers of children with autism.

One of the mothers, Jennifer Meyer, of St. Charles, said she took her then two and a half year old son Spencer to three different neurologists when he first started showing signs of autism because "just one wasn't good enough for me."

Of the three doctors Meyer contacted, she said all recommended the ABA therapy mentioned in both bills. Meyer said she spent $2,000 on ten weeks of therapy for Spencer, now four-years-old, a cost that would be covered under the proposed legislation. She said the therapy was a necessary medical expense, as opposed to other treatments, like the gluten-free diet her son maintains.

"If I want to buy a $7 loaf of bread," Meyer said, "that's on me. I don't need government help for that."

Miriam Cullimore, an associate trainer at TouchPoint Autism Services in Columbia, said ABA therapy is "one of the only scientifically proven treatments that shows consistent improvement."

According to Cullimore, a family participating in ABA therapy would develop specific goals for their child, like reading social cues or using sign language and work to reinforce the desired behavior.

"For example, eye contact tends to be very difficult," Cullimore said. "So to improve eye contact, we'll hold an object next to our face, an item they really like, and we give them the item and lots of praise after they make that eye contact."

The committee took no immediate action on the bill. The House version was referred to a Senate committee on March 18, but a hearing has not been scheduled at this time.