Date: 04/29/2009
Final
BILL SUMMARY for SB09-244
HOUSE COMMITTEE ON BUSINESS AFFAIRS AND LABOR
| Votes: View--> | Action Taken: |
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11:27 AM -- Senate Bill 09-244
Representative Primavera presented Senate Bill 09-244, which requires all health insurance policies which are subject to state regulation to provide coverage to assess, diagnose, and treat autism spectrum disorder (ASD). The bill includes a definition of terms including ASD, applied behavior analysis, autism service providers, and treatment plan. Representative Stephens pointed out that Medicaid and the Children's Basic Health Plan (CHP+) are not required under the bill to provide coverage. Representative Primavera responded that Medicaid provides services to children with autism under the Home- and Community-Based Autism waiver. Representative Primavera provided data regarding how much premiums have increased in other states where a similar bill passed. The committee discussed the fiscal note dated April 28, 2009.
Several handouts were provided to the committee including:
- a fact sheet from the sponsor of the bill in support of the bill (Attachment A);
- written testimony in support of the bill from Adrienne Paradis (Attachment B);
- written testimony in support of the bill from Lu Etta Loeber (Attachment C);
- a statement from the Colorado Department of Education in support of the bill (Attachment D);
- a fact sheet in support of the bill from the Autism Society of Colorado (Attachment E);
- excerpts from the Mandate Commission Report on Senate Bill 09-244 (Attachment F); and
- a summary of changes to health insurance law and costs for Colorado employers from 1998-2009 (Attachment G).
11:41 AM -- Dr. Helena Huckabee, Emerge, P.C., spoke in support of the bill. Dr. Huckabee stated that she is a clinical psychologist and a mother of a child with autism. Dr. Huckabee provided her written testimony and an article titled "The Lifetime Distribution of the Incremental Societal Costs of Autism" to the committee (Attachments H and I). Dr. Huckabee spoke to the services she provides to children with autism. Members of the committee asked the witness questions.
12:03 PM -- Dr. David Hatfield, representing himself, spoke in favor of the bill. Dr. Hatfield provided a written handout to the committee which included a definition of applied behavior analysis (ABA) (Attachment J). Dr. Hatfield stated that as a clinical psychologist and board certified behavior analyst, that he believes ABA is a legitimate intervention technique that can significantly improve the core symptoms for individuals with ASD. He stated that ABA is a stand alone practice, not grouped with educational or medical treatments for autism. He stated that one of the arguments against ABA is that it is an educational practice and that health insurance carriers should not be responsible to pay for an educational practice. Dr. Hatfield spoke about other states that have implemented similar policies.
12:17 PM -- Betty Lehman, Executive Director, Autism Society of Colorado, testified in support of the bill. She spoke to the services offered though Medicaid, specifically referencing the children's extensive support and the children with autism waivers. She stated that there are approximately 75 children on the Children with Autism waiver. Ms. Lehman stated that autism is 90 percent treatable. She stated that the Commission on Mandated Health Insurance provided a report which stated that the Division of Insurance calculated that if the bill were to pass, there would be an increase to premiums of approximately $4.12 monthly or about $49 annually. She spoke to the benefits of treatment which cannot be calculated in a fiscal note. Ms. Lehman stated that for every $1 spent on early intervention services, it saves $12. Ms. Lehman stated that she does not believe any other significant health illness like autism is excluded from coverage.
12:28 PM -- Gregory Goodman, parent of a child with autism, spoke in support of the bill. Mr. Goodman provided his written testimony to the committee (Attachment K). Mr. Goodman highlighted the handout which describes changes to health insurance coverage. He stated that the chart demonstrates that health insurance premiums have not increased when an additional health insurance mandate was implemented. He stated that health insurance mandates do not increase costs to premiums.
12:34 PM -- Dr. Deb Efird, American Academy of Pediatrics, practicing at the Children's Hospital, spoke in favor of the bill. She stated that she has a child with autism. She spoke to how much her child's condition improved after receiving applied behavior analysis treatment.
12:39 PM -- Heidi Loeffel, paralegal from Ewing and Ewing, PC, testified that the law firm she works for recently worked on a case in which a child with autism was denied coverage because the child received ABA therapy. She stated that the case involved Kaiser Permanente. Ms. Loeffel stated that the claim of denial was based on the fact that ABA is not a medically recognized treatment. Ms. Loeffel provided paperwork regarding the lawsuit (Attachment L).
12:43 PM -- Julie Cook, board member of the Alpine Autism Center and a parent of a child with autism, spoke in support of the bill. She stated that she is a small business owner and pays approximately $1,000 for her and her husband's health insurance premiums. She stated that her insurance does not cover ABA therapy, which her daughter receives about once a week. Ms. Cook stated that the treatment of cancer is on the same level as the treatment of autism. She stated that a health insurance carrier could not deny the treatment of cancer, and asked why it would then be able to deny treatment of autism.
12:50 PM -- Jill Tappert, parent of a child with autism, stated that she recently won an arbitration case against Anthem BlueCross BlueShield to cover ABA therapy. She stated that the judge in the case ruled that ABA therapy was considered medically necessary and not experimental, and that it is the standard of care in treating autism. Ms. Tappert provided her written testimony to the committee (Attachment M). She spoke to how much her child has improved since implementing ABA autism treatment.
01:07 PM -- The written testimony from Phillip Strain was provided to the committee (Attachment N).
01:08 PM -- Sarony Young, Family Voices Colorado, stated that Family Voices helps individuals file appeals of claims for the coverage for ABA therapy that are denied. She testified in support of the bill.
01:13 PM -- Sharlene Yabe, Colorado State Association of Health Underwriters, spoke in opposition to the bill. Ms. Yabe stated that the bill will add to the already high costs of premiums. She stated that the underwriters set criteria with regard to what types of illnesses to cover. She stated that the bill will not increase access to health care, will not decrease the cost of premiums, and will likely drive out healthy individuals who will not pay any more money for increased premiums. She urged the committee to wait until national reform has been put in place before passing another health insurance mandate. Representative Bradford asked why the insurance industry has not been more proactive in dealing with this issue considering other states have passed mandates to cover the treatment of autism. Ms. Yabe stated that the insurance industry has been active, but was not asked to the table for discussions regarding this particular bill.
01:28 PM -- Mark Mannino, parent of a child with autism, spoke in favor of the bill. Mr. Mannino described the improvement his child achieved after receiving ABA therapy. His written testimony was provided to the committee (Attachment O).
01:31 PM
Senate Bill 09-244 was taken off the table.