Autism bill headed to governor

May 19--MONTGOMERY -- The Alabama House of Representatives early Thursday morning approved a bill that would require insurers to cover the cost of therapy for children with autism.

The vote to agree with two Senate changes made to the bill and send it on to Gov. Kay Ivey was taken around 2 a.m. -- near the beginning of a new legislative day that came after the previous one was lost to a filibuster lodged by House Democrats and inflamed by a spat over an email on Wednesday.

The bill's sponsor, Rep. Jim Patterson, R-Meridianville, called its passage a victory, and attributed the win to parents of autistic children.

"It should show the public that their lobbying counts a lot, too," Patterson said.

Supporters in both chambers said the bill faced intense pressure from other interests, as well -- chief among them the state's largest insurer, Blue Cross Blue Shield -- and Patterson said the compromise version passed Thursday was likely the best he could get.

"More progress could be made, but this is a starting point," he said.

Bama Hager, program director for the Autism Society of Alabama, wrote in an email Thursday the organization was encouraged by the bill's passage, which offers parents of children with autism "improved access to medically necessary therapy."

The bill requires coverage of therapeutic and medical treatment for children with autism spectrum disorders, including a unique form of therapy called applied behavior analysis, but only until the age of 18. It also mandates that state-run insurance funds for employees and teachers cover those treatments, but not until fiscal year 2019.

Supporters pushed back against any age cap, arguing that autism requires lifelong therapy and maintenance. Those who supported the caps, meanwhile -- chief among them Sen. Trip Pittman, R-Montrose -- saw them as a way to control costs.

Pittman on Tuesday characterized those caps as the only way to hedge the state's liability in a bill whose costs haven't been and, he said, could not be quantified.

The bill as passed also lacked an original requirement for insurers to report to the state the number of children treated under the provision. Rep. Rod Scott, D-Fairfield, questioned that removal.

"Why was the reporting taken out? It doesn't make sense to me," Scott said.

Patterson agreed, and said he was discouraged to see it gone.

"There's a reason it was taken out, and it's not a good reason," he said Thursday morning. After the bill won Senate approval Tuesday, Patterson said the reporting requirement would've showed that cost estimates lawmakers received from Blue Cross Blue Shield "were way off."

Patterson said he'd follow up with Ivey to see that some provision to ensure accountability made it into the law.

The head of the state's largest provider of applied behavioral analysis, meanwhile, says she sees serious problems with the bill as passed.

"This is going to exclude something like 87 percent of the state's population," said Ashlie Walker, owner of Milestones Behavior Group in Vestavia Hills. "That's not OK."

There's no mandate for insurers to cover therapy in individual plans, and they're only required to cover larger businesses. Combined with the age cap and delay in coverage for state-funded pools, the law will serve a far smaller number than originally intended, Walker said.

"Sixteen-year-olds right now will never get ABA coverage in Alabama," Walker said, using an acronym for the kind of therapy her business specializes in.

Early intervention is the best treatment for children diagnosed with autism spectrum disorders, she said, and because there likely will be a delay of nearly two years for many children in the state, "that window is really closing."

Staff writer Zach Tyler: 256-235-3564. On Twitter @ZTyler_Star.

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