Autism coverage clears House [Topeka Capital Journal (KS)]

Health care coverage long sought by the parents of autistic children could become mandatory in Kansas if a bill that passed the House 92-30 this week is signed into law.

The bill, authored by Rep. Arlen Siegfreid, R-Olathe, requires that private health insurers provide coverage for behavioral therapy and other treatments for children up to age 19 who are clinically diagnosed with conditions along the autism spectrum.

When Rep. John Rubin, R-Shawnee, brought it to the House floor, it touched off more than four hours of debate, with opponents saying the mandate was burdensome to business and unfair to children on public health care.

But Rubin successfully argued that study after study has shown autistic children who receive early treatment are more likely to be mainstreamed in school and employed after school, which saves money in the long term.

"This bill is not only the right thing to do for kids and their families that have clinically diagnosed autism," Rubin said on the House floor. "It's also fiscally responsible."

But the bill may ultimately be held up by questions about how to pay for state obligations that were added later. Rep. Brenda Landwehr, R-Wichita, and others said that if the treatments are good for privately-insured children, they would be just as good for those on Medicaid -- an argument that proved difficult to refute.

By the time the bill passed, Rep. Charlotte O'Hara, R-Overland Park, had successfully attached an amendment to provide the same coverage for children on public health care, which Rubin estimated will cost the state $25 million.

"I'd like to figure out where else in the budget we're going to take the money from," Rubin said in a phone interview Thursday. "I agree with that. I agree with spending the money for it, except I would have liked it worked in a more orderly way."

Another amendment to the bill, attached by Rep. Jim Denning, R- Overland Park, would cap the cost of the new autism coverage to insurance policyholders at $0.31 per policyholder, per month.

Rubin said the underlying bill requires up to $36,000 of coverage per year for autistic children from birth to age 6 and $27,000 up to age 19. Per Denning's amendment, that benefit would be reduced if enough people access the benefits to push the costs above the $0.31 threshold.

Rubin said a pilot program instituted in 2010 that provided the autism coverage to state employees averaged about $0.14 cents per policyholder, per month, but he would expect that to increase as more parents become aware of the coverage and access it. The $0.31 limit is based on the costs of similar coverage in Missouri.

That amendment failed to mollify some conservative leery of mandates.

Despite what he called "immense pressure" from autism advocates via social media, Rep. Scott Schwab, R-Olathe, voted against the bill, calling it bad policy.

"We're all adults," Schwab said on the House floor. "Forget about the pressure and make a good decision."

O'Hara said the insurance industry had not had enough opportunity to weigh in on the bill and recommended sending it back to committee. But Siegfreid, the House Majority Leader, strongly disagreed.

"They chose not to testify," Siegfreid said of insurers. "That was their choice."

The House Democrats came out in strong support of the bill, with House Minority Leader Paul Davis, D-Lawrence, saying raising an autistic child provides "some of the most unbelievable challenges any parent can have."

Rep. Judith Loganbill, D-Wichita, said some insurance providers cover penile implants for erectile dysfunction and they should be "called to task" for not covering autism in children.

"What we're asking them to do is, pardon my French, suck it up," Loganbill said.

Andy Marso can be reached at (785) 233-7470 or [email protected]. Follow him on Twitter @andymarso.