January 20, 2010

Autism coverage gains momentum in Missouri Legislature
By Virginia Young
POST-DISPATCH JEFFERSON CITY BUREAU

JEFFERSON CITY — Families with autistic children appear likely to gain insurance coverage in Missouri next year, but how much coverage will be the focus of a heated debate that kicked off Tuesday.

In jammed hearing rooms, supporters of an insurance mandate urged legislative committees to make Missouri the 15th state, including Illinois, to require that all health insurance policies pay for diagnosis and treatment of the fast-growing brain disorder.

The issue has been on the front burner since Gov. Jay Nixon, a Democrat, criticized the Republican-led House for killing the bill last year. GOP leaders have promised to make it a priority this year. To get a jump on Nixon, both the House and Senate held autism hearings on the eve of Nixon's "State of the State" speech, which he will deliver at 7 tonight and which is expected to highlight the issue.

In autistic children, the brain does not develop normally, causing an array of problems with communication and social interaction. National studies have found the disorder affects roughly one in 100 children — one in 83 in the St. Louis region, the highest rate in the country, according to an expert who testified Tuesday. 

The good news, witnesses said, is that one-on-one therapy called applied behavioral analysis, or ABA, has been successful in treating autism, especially if the therapy begins at a young age.

Half of the children treated as preschoolers will enter first grade "indistinguishable from their peers," said Lorri Unumb, senior counsel for a national group called Autism Speaks and the mother of an 8-year-old son with autism.

But the therapy is expensive, costing families tens of thousands of dollars a year, depending on the severity of the child's disorder. Treatment involves three tiers — a consultant for three to six hours a month, a supervisor for six hours a week and a therapist in the home for as much as 40 hours a week.

Insurers agreed that the therapy can improve brain functioning, but they argued that it works well only for young children — say, younger than 7. The therapy has "very limited" efficacy for older children, said Dr. Blake Williamson, a vice president and senior medical director at Blue Cross Blue Shield of Kansas City.

Insurers oppose the bill's guarantee of up to $72,000 in treatment for children and adults up to age 21. Instead, Williamson suggested a $32,000 annual benefit up to age 7, with lesser benefits after that.

But in focusing on ways to scale back the bill rather than kill it, the opponents' position showed their recognition that the measure has broad bipartisan support. 

The insurance industry generally opposes all mandates, contending that they increase costs for everyone, forcing some people to drop their coverage and some companies to quit providing insurance for employees.

Indeed, insurers said the autism mandate could raise premium costs in the state by at least 3 percent.

Advocates for the autism bills contested that point, saying that in states that require the coverage, costs have risen less than 1 percent.

However, David Smith, representing Anthem Blue Cross Blue Shield of Missouri, said those comparisons may not be valid. For example, he said that Indiana has more school programs for autistic children than Missouri does, and spends twice what Missouri does on such initiatives.

The one thing that was clear Tuesday was that Republicans and Democrats alike want to address the issue during this election year before going home to constituents who struggle with the disorder or know families who do.

Legislators heaped praise on the bills' sponsors, Rep. Dwight Scharnhorst, R-St. Louis County, and Rep. Jason Grill, D-Parkville, for bringing the bills forward. In a sign of the popularity of the issue, Rep. Rob Schaaf, R-St. Joseph, ribbed Scharnhorst for accidentally failing to list Schaaf as a co-sponsor.

While the House bills are similar, Scharnhorst's is broader, requiring $72,000 in benefits. Grill said he attempted a compromise, modeling his bill after a measure that passed the Senate last year. It would require coverage of up to $55,000 a year in treatment up to age 15.

Rep. Kevin Wilson, R-Neosho, heads the House committee that will craft a bill to send to the House floor for debate. Wilson said he wants to look at the age and benefit limits, as well as credentials required for therapists providing the service.

"We're going to be aggressive but not rush something that's not right," Wilson said.

Still up in the air: whether to exempt or provide an opt-out provision for small businesses. Some of the proposals would let businesses with 50 or fewer employees seek exemptions if they could prove their premiums would rise by at least 5 percent as a result of the autism coverage.

"I know this bill's going to pass this committee," said Brad Jones, a lobbyist for the National Federation of Independent Businesses. "I just ask we keep the small business community in mind."

December 31

December 3, 2009

Missouri lawmakers try again on autism insurance

JEFFERSON CITY, Mo. — Missouri’s top House official pledged his support for legislation requiring health insurers to cover an expensive therapy for autistic children.

Legislation proposed for the 2010 session would require group health insurance plans to cover up to $72,000 of behavioral therapy per year for autistic people under age 21. Businesses with 50 or fewer employees would be exempt if they proved the requirement would raise the cost of their premiums by at least 5 percent.

The legislation is similar to — and in some ways, broader than — legislation that passed the Senate earlier this year but never received a House vote because Speaker Ron Richard said there wasn’t a consensus.

On Wednesday, Richard joined the lead House sponsor, Rep. Dwight Scharnhorst, in a media conference call outlining the latest legislation and pledged it would be the first bill on the House calendar when the session starts in January.

“We want to help these kids and families, and we’ve committed to do that,” said Richard, R-Joplin.

Democratic Gov. Jay Nixon was to travel the state with several other lawmakers Thursday, promoting the legislation. In July, Nixon had sharply criticized Republican House leaders for not allowing a vote on the autism legislation.

“Governor Nixon is pleased that both the House and Senate have prefiled bills that meet the criteria he laid out earlier this year for successful autism insurance coverage legislation,” Nixon spokesman Jack Cardetti said.

Although consensus may be forming among top elected officials, the Missouri Insurance Coalition said Wednesday that it remains opposed to requiring autism coverage.

The 2010 legislation “sounds very expensive, sounds like a full blown mandate, sounds like special interests may get served at a very high price tag while others who are struggling to pay premiums may get priced out of the market,” insurance coalition executive director Calvin Call said.

Insurers’ lobbyists told lawmakers during the last legislative session that requiring autism coverage could raise premiums by more than 3 percent and prompt thousands of people to drop their health insurance.

An actuarial analysis by the consulting firm Oliver Wyman, conducted for the advocacy group Autism Speaks, estimated an autism insurance requirement would result in a less than 1 percent increase in the cost of premiums.

Nationally, about 1 in 150 children are diagnosed with a form of autism.

At issue is a treatment known as “applied behavioral analysis.” Some parents say it dramatically improves their children’s condition, but it costs more than $50,000 a year and is not covered by insurers in Missouri.

Fourteen states have laws requiring coverage of “medically necessary, evidence-based autism therapies” such behavioral analysis services, according Autism Speaks.

After autism legislation failed in the 2009 session, Richard appointed a House committee to continue working on the issue and Nixon held news conferences pushing for the legislation. Sens. Scott Rupp, R-Wentzville, and Eric Schmitt, R-Glendale, joined in several rallies around the state.

“Missouri families living with autism spectrum disorders — and tens of thousands more concerned citizens and supporters of autism insurance reform — have spoken loudly and clearly that our state must address this urgent matter so that families can afford the necessary diagnosis, treatment and support services,” Rupp said in a written statement Wednesday.

 October 16, 2009

 "How Dollars and Legislation Go Hand in Hand"

Article By Stee Krasky and Jason Noble of Kansas City Star

•A bill aimed at requiring insurance companies to provide coverage for the diagnosis and treatment of autism spectrum disorders easily passed the GOP-controlled Senate on a 29-2 vote and cleared two House committees.

But House leadership opted not to bring the bill to the floor, despite widespread support. Insurance companies opposing the bill followed up that decision with at least $40,000 in donations to House Speaker Ron Richard and floor leader Steven Tilley, a client of political consultant Rod Jetton.

Gov. Jay Nixon, a Democrat, was prepared to sign the measure. During the summer he complained about the bill’s defeat, saying: “The only argument is that the insurance industry didn’t want it. And that’s not an argument.”

Of the campaign donations, Nixon said: “People can draw whatever conclusions they want.”

When asked whether the contributions played into Richard’s decision not to advance the bill, spokeswoman Kristen Blanchard said: “Absolutely not.”

Despite public comments from lawmakers in support of the bill, Blanchard said, many privately expressed reservations about it — so many, in fact, that the bill’s passage was unlikely.

“When this bill came to the floor, it was not going to pass,” she said, adding that Richard “was 100 percent sure it wouldn’t pass.”

Tilley said he personally supported the bill but deferred to Richard’s decision not to place the bill on the legislative calendar for consideration.

September 10, 2009

Jefferson City – An interim committee charged with studying the impact of Autism Spectrum Disorders on Missouri families will hold its first public hearing during the week of Veto Session. Jonathan Lorenz reports from the State Capitol.

Click here to view the video feature on the House Interim Committee on Autism Spectrum Disorders.

The House Interim Committee on Autism Spectrum Disorders chaired by Rep. Dwight Scharnhorst (R-St. Louis) will take public testimony during a hearing scheduled for Tuesday, September 15 at 12 p.m. in House Hearing Room 7 in the State Capitol.

Click here for list of House Interim Committee on Autism members

August 10, 2009

Article By Tony Messenger
St. Louis Post-Dispatch

JEFFERSON CITY — It’s not just Democrat Gov. Jay Nixon who is pushing the autism insurance bill.

St. Louis area senators Scott Rupp of Wentzville and Eric Schmitt of Glendale — both Republicans — have established a Web site pushing the autism insurance coverage bill and in September will hold a public rally kicking off support for the legislation next session.

Rupp and Schmitt — who has a son with autism — were key supporters of the bill that passed the Senate last year but never received a vote in the House. Nixon pushed the bill as an early legislative priority in a state flyaround last week.

Meanwhile, House Speaker Ron Richard, R-Joplin — who never put the bill on the calendar last year — is criticizing Nixon for politicizing the issue. Richard has appointed an interim committee to study the issue of mandating autism insurance. The committee hasn’t met yet.

Rupp and Schmitt’s rally is on noon on Sept. 20 at The Meadows at Lake St. Louis.

July 17
MO House News

Jefferson City – Missouri House Speaker Ron Richard, R-Joplin, announced the creation of an Interim Committee on Autism Spectrum Disorders. This committee is charged with the responsibility of reviewing and making recommendations on issues pertaining to the regulation of insurance and other matters impacting the lives of those diagnosed with Autism.

“We have spent months gathering facts and researching what answers are most effective in aiding Missourians with Autism,” said Speaker Richard. “I am tasking the members of the Interim Committee on Autism Spectrum Disorders with finding a responsible, effective solution that all sides can agree on,” he finished.

Richard named Rep. Dwight Scharnhorst, R-St. Louis, to chair the committee. As Chairman, Scharnhorst is given the responsibility of directing committee meetings and ensuring that all members work together to find a meaningful legislative solution to the growing Autism epidemic.

“Representative Scharnhorst has been an advocate for Autism in the past and I am confident that he will continue to be a strong leader on the issue moving forward,” said Speaker Richard.

“I thank Speaker Richard for his dedication to this matter and for asking me to chair the Interim Committee on Autism Spectrum Disorders. Our members will work together to review the facts and produce progressive measures that will improve the lives of Missouri families who deal with Autism. I am confident that through this interim committee, we will be able to move closer to a definitive solution.” said Representative Scharnhorst.

The interim committee will hold hearings in the coming weeks.

In addition to Rep. Scharnhorst, the committee is made up of the following members:

Representative Wayne Cooper, Vice Chairman
Representative Sue Allen
Representative Ron Casey
Representative Mike Colona
Representative Sally Faith
Representative Jeff Grisamore
Representative Denny Hoskins
Representative Tishaura Jones
Representative Shelley Keeney
Representative Michele Kratky
Representative Chris Molendorp
Representative Gina Walsh
Representative Terry Witte

July 8, 2009
Capitol Calling

Nixon bashes House for not passing autism insurance bill
On a day where Gov. Jay Nixon signed a number of bills on a number of different subjects, it was legislation that failed to pass that rankled the first-term Democratic governor the most.

While the Senate passed legislation mandating insurance companies to cover ailments related to autism disorder, the House failed to act on the last day of session. It was cited by Nixon as one of the chief disappointments of the legislative session.

How rankled was Nixon? Judge for yourself! 

WATCH THE VIDEO!

May 27, 2009

KC Star:  After catching flak for House inaction on a bill requiring insurance companies to cover autism, House Speaker Ron Richard promised Wednesday to bring all the sides together this summer and file a bill next winter.

"I have instructed several of my chairman to work to compose a plan that will bring insurance companies and autism advocacy groups together for a compromised solution to this very real problem," Richard, a Joplin Republican, said in a statement.

He also said: "Missourians can expect a solid health-care plan, covering autism patients and uninsurable Missourians, mid-summer and expect a bill to be filed in December and taken up on the floor in the coming Legislative Session."

The comments come a day after two Republican senators decried in a St. Louis Suburban Journals article the House's refusal to take up an insurance-coverage bill before the legislative session ended May 15.

One of the senators, Scott Rupp, of Wentzville, blamed "House leadership" for the bill's failure

 April 6, 2009 

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