Bill Summary for Bill Number SB09-244

Date: 04/29/2009

Final
BILL SUMMARY for SB09-244

HOUSE COMMITTEE ON BUSINESS AFFAIRS AND LABOR

Votes: View-->	Action Taken:
Moved to adopt prepared amendment L.020 (Attachmen Moved to adopt prepared amendment L.024 (Attachmen Moved to adopt prepared amendment L.025 (Attachmen Moved to adopt prepared amendment L.030 (Attachmen Moved to adopt prepared amendment L.031 (Attachmen Moved to adopt Section A of amendment L.020 (Attac Moved to refer Senate Bill 09-244, as amended, to	TIE Pass Without Objection Pass Without Objection Pass Without Objection PASS PASS PASS

04:27 PM -- Senate Bill 09-244

Senate Bill 09-244 was put back on the table and witness testimony reconvened.

04:30 PM -- Daniel West, representing himself, spoke in support of the bill. Mr. West provided his written testimony to the committee (Attachment V).

04:37 PM -- Travis Berry, Colorado Competitive Council (C3), spoke in opposition to the bill. He stated that his heart goes out to the families who have children with autism. He spoke to the exclusions in the bill for state employees and self-funded health insurance plans. He stated that many large companies are self-funded. He said that he would caution the committee against creating unrealistic expectations. Committee members asked questions of the witness. Mr. Berry spoke to the how the bill may affect businesses. He stated that it is irresponsible in these economic times to place the burden solely on business who provide health insurance.

04:48 PM -- Tony Gagliardi, National Federation of Independent Business (NFIB), spoke in opposition to the bill. He stated that it was a difficult position to be in opposition to the bill. He provided information regarding NFIB's membership, which he said has been increasingly shrinking given the current state of the economy. He stated that each additional health insurance mandate on small group policies increases premiums by approximately 35 percent. He stated that businesses that offer quality benefits packages are competitive and aim to keep qualified employees, but at some point, a small business owner simply cannot afford to continue to pay the increased costs of premiums. He spoke to the mandated coverage placed on businesses. He spoke to the increasing price of premiums for small group policies. He stated that the bill creates two classes of children. He stated that the there is a significant cost shift to small business. He stated that any type of treatment covered should be evidence-based.

05:03 PM -- Donnah Moody, Colorado Association of Commerce and Industry (CACI), spoke in opposition to the bill. She spoke specifically to ABA therapy and the costs of that treatment. She asked the committee to refer to the fiscal note when Medicaid and the Children's Basic Health Plan were included. She stated that the fiscal note was approximately $80 million. She stated that the bill creates a niche specific to autism, and that it opens the door to dismantling the health insurance industry.

05:10 PM -- Ben Price, Colorado Association of Health Plans, spoke in opposition to the bill. Two handouts were provided to the committee, the 2009 State Autism Mandate Bills Cost Estimates and a copy of the draft of the working principles provided to the Autism Society of Colorado (Attachments W and X). Mr. Price stated that the 2009 State Autism Mandate chart compares bills in other states to Colorado, and the actual cost of premiums. He concurred with Mr. Gagliardi's testimony regarding the cost shift onto small businesses. He also spoke to the ABA therapy model and whether it is an educational technique or a medical treatment. Mr. Price also stated that the bill is fairly broad regarding how it defines autism treatment providers.

05:27 PM -- Linda Daniel, Rocky Mountain Health Plans, testified in opposition to the bill. She stated that it is difficult to oppose the bill. She stated that remaining fiscally responsible may not be realistic if the bill is passed. She concurred with Ms. Moody's testimony regarding carving out a specific niche for a particular group of individuals with a specific illness. She stated that the bill will raise premiums. She stated that their plans may have to decrease coverage in other areas to cover the costs associated with this bill. She also stated that she is not sure if there are enough qualified providers to serve all the children with autism.

05:34 PM -- Susan Cox, Kaiser Permanente, testified in opposition to the bill. She provided 3 handouts, an article titled "Autism Overview: What We Know," another article from the American Academy of Pediatrics titled "Management of Children with Autism Spectrum Disorders," and a handout from the National Institute of Mental Health regarding modalities of ASD (Attachments Y, Z, and AA respectively). She pointed out the handout from the National Institute of Mental Health states that there is no single best treatment for children with ASD. She stated that Kaiser supports evidence-based treatments. She stated that bills in other states which have mandated significantly less in coverage have been postponed indefinitely. Ms. Cox stated that the bill is too specific regarding the treatment of autism. She stated that it is not fair to place the majority of the burden on private health insurance policy holders. She stated that there is a difference of opinion on the best modality for the treatment of ASD. Ms. Cox stated that Kaiser has not had sufficient time to review several amendments and their effects. She stated that the cost to Kaiser would be approximately 15 percent of their mental health budget in order to care for less than 1/1000 of the population served.

05:51 PM -- Dr. Jean Milofsky, Chair of Psychiatry Department, Kaiser Permanente, described how Kaiser Permanente treats children with autism. She spoke to the need to have control over a treatment plan. Committee members asked questions of the witness.

06:10 PM

At the request of Representative Gagliardi, Mr. Price from the Colorado Association of Health Plans provided a copy of the numbers he referenced in his testimony (Attachment BB). The committee took a brief recess.

06:34 PM

The committee reconvened. The committee discussed several amendments.


BILL:	SB09-244
TIME:	06:42:12 PM
MOVED:	Stephens
MOTION:	Moved to adopt prepared amendment L.020 (Attachment CC). Representative Primavera asked the committee to strike line 5 of the amendment. Amendment L.020 puts back in the coverage for state employees. Representative Stephens withdrew her motion. Representative Liston withdrew his second.
SECONDED:	Liston
		VOTE
	Balmer
	Bradford
	Gagliardi
	Liston
	Priola
	Ryden
	Scanlan
	Soper
	Stephens
	Casso
	Rice

Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Withdrawn


BILL:	SB09-244
TIME:	06:48:17 PM
MOVED:	Gagliardi
MOTION:	Moved to adopt Section A of amendment L.020 (Attachment CC). Section A of amendment L.020 includes lines 1 through 4. The motion passed on a 6-5 roll call vote.
SECONDED:	Casso
		VOTE
	Balmer	No
	Bradford	No
	Gagliardi	Yes
	Liston	No
	Priola	No
	Ryden	Yes
	Scanlan	Yes
	Soper	Yes
	Stephens	No
	Casso	Yes
	Rice	Yes

Not Final YES: 6 NO: 5 EXC: 0 ABS: 0 FINAL ACTION: PASS


BILL:	SB09-244
TIME:	06:50:16 PM
MOVED:	Balmer
MOTION:	Moved to adopt prepared amendment L.024 (Attachment DD). The sponsor explained the amendment. Debbie Haskin, Office of Legislative Legal Services, provided an explanation of the amendment. The motion passed without objection.
SECONDED:	Priola
		VOTE
	Balmer
	Bradford
	Gagliardi
	Liston
	Priola
	Ryden
	Scanlan
	Soper
	Stephens
	Casso
	Rice

Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	SB09-244
TIME:	06:51:21 PM
MOVED:	Soper
MOTION:	Moved to adopt prepared amendment L.025 (Attachment EE). The sponsor explained the amendment. The motion passed without objection.
SECONDED:	Gagliardi
		VOTE
	Balmer
	Bradford
	Gagliardi
	Liston
	Priola
	Ryden
	Scanlan
	Soper
	Stephens
	Casso
	Rice

Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	SB09-244
TIME:	06:55:25 PM
MOVED:	Priola
MOTION:	Moved to adopt prepared amendment L.030 (Attachment FF). The motion passed without objection.
SECONDED:	Stephens
		VOTE
	Balmer
	Bradford
	Gagliardi
	Liston
	Priola
	Ryden
	Scanlan
	Soper
	Stephens
	Casso
	Rice

Not Final YES: 0 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: Pass Without Objection


BILL:	SB09-244
TIME:	06:56:54 PM
MOVED:	Stephens
MOTION:	Moved to adopt prepared amendment L.031 (Attachment GG). The amendment changes the benefit caps for coverage. The motion passed on a 10-1 roll call vote.
SECONDED:	Balmer
		VOTE
	Balmer	Yes
	Bradford	Yes
	Gagliardi	Yes
	Liston	No
	Priola	Yes
	Ryden	Yes
	Scanlan	Yes
	Soper	Yes
	Stephens	Yes
	Casso	Yes
	Rice	Yes

Not Final YES: 10 NO: 1 EXC: 0 ABS: 0 FINAL ACTION: PASS

07:02 PM

Representative Primavera provided a wrap-up to the bill. She stated that the state, the education system, the federal government, and the military pay their share to treat children with autism. She stated that it is now time for insurance companies to step up and cover their share.


BILL:	SB09-244
TIME:	07:05:25 PM
MOVED:	Gagliardi
MOTION:	Moved to refer Senate Bill 09-244, as amended, to the Committee of the Whole. The motion passed on a 9-2 roll call vote.
SECONDED:	Stephens
		VOTE
	Balmer	Yes
	Bradford	No
	Gagliardi	Yes
	Liston	No
	Priola	Yes
	Ryden	Yes
	Scanlan	Yes
	Soper	Yes
	Stephens	Yes
	Casso	Yes
	Rice	Yes

Final YES: 9 NO: 2 EXC: 0 ABS: 0 FINAL ACTION: PASS

07:07 PM

The committee adjourned.