TRACKING AUTISM INSURANCE LEGISLATION

June 10, 2010
Governor Nixon to sign autism insurance legislation
HB 1311 / HB 1341 becoming law!

LEGISLATION TO BE SIGNED:  Today, the Governor begins a tour of Missouri to various locations to sign legislation to bring autism insurance reform to Missouri.  HB 1311/1341 (Scharnhorst/Grill) requires private insurers in Missouri to provide coverage for the diagnosis and treatment of autism spectrum disorders. 

Families with private health insurance have had great difficulty in getting coverage for physician-prescribed autism-related treatments, and many individuals have not been able to purchase policies for their children with autism.  Many are anxiously awaiting the implementation of the new law, which will to into effect in January of 2011. 

The legislation is the result of bipartisan efforts and bipartisan support, with the filed bills having a long list of sponsors and co-sponsors from both sides of the aisle.  2010 was the third year that legislation had been filed and pursued by the autism community.

Governor Nixon has been a long-time supporter of autism issues, and autism insurance reform has been on his list of priorities since the failed attempt in the 2009 legislative session.

EXECUTIVE SUPPORT:  "Children with autism deserve to have the life-changing treatments they so badly need without getting caught up in the tangle of insurance bureaucracy," said Gov. Nixon in August in a speech at the Touchpoint Center for Autism in St. Louis.

"It is clear to me ... that action on autism coverage legislation can wait no longer. A bill that guarantees that insurance providers will cover the most effective treatments for autism must pass this legislative session and it must include substantial provisions that make real differences for real families," said Gov. Nixon.

The Governor's continued support and attention to the issue was a critical driving force to seeing the legislation through to completion this session. 

In his State of the State address this year, Governor Nixon brought autism again to the forefront,  "I have stood with Democratic and Republican legislators on this issue, and laid out the key elements of a bill that we all know will make a real difference in these children's lives."

DETAILS:  The final version of the legislation includes provisions to cover the much-discussed therapy of ABA (up to $40,000 per year, up to age 18) and state licensure provisions for ABA therapists.  Other treatments are not to be subject to visit limits or dollar amounts.  For small business policies, there is an "opt-out" provision if in the future their premiums would be adversely affected by the addition of this specific coverage.

SPONSOR QUOTES:  "I am very happy with the final product," lead Senate sponsor Sen. Scott Rupp said after the bill's passage. "This will dramatically affect thousands of families throughout Missouri."

 "This is a major victory for the many Missouri families who have worked long and hard to see this legislation become reality," said Rep. Jason Grill, the sponsor of HB 1341.  "We have had so many individuals who have worked diligently over the last several years to reach this point.  I am proud to be part of passing this landmark legislation that will make a real difference in the lives of so many children with autism."

FOR A COMPLETE LIST OF BILL-SIGNING LOCATIONS: 

Visit "Governor's Tour Schedule for MO Autism Bill Signings" on Facebook.

THE BUZZ:   

Please be aware that this legislation only affects certain types of policies.  Estimates are that the state mandate will affect 30 to 40 percent of the insurance market. Most large employers' plans are self-funded (ERISA plans) which can only be federally regulated. The legislation includes a "mandated offering" for individual policies, meaning that those policies will now have to offer an option for this coverage.People with individual insurance policies would have the option to buy the coverage but it would not be required.

If families have questions about whether or not this legislation will affect their policies, a good place to start is to contact the employer's HR department to ask if their company plan is subject to changes in Missouri state law.

MAY 12:  TRULY AGREED TO and FINALLY PASSED 

HB 1311 passes both the House and the Senate - now awaits Governor's signature

LEGISLATIVE UPDATE

May 12, 2010:  Jefferson City

For those tracking autism insurance legislation in Missouri, the magic words came today ...
TRULY AGREED TO AND FINALLY PASSED
These are the words listed as you look up the official status of the autism insurance bill that crossed the finish line, HB 1311. 
   Bipartisan support and appreciation were in the air in the state capitol with the final version of HB 1311 requiring insurance coverage for the diagnosis and treatment of autism spectrum disorders passing overwhelmingly in both the Missouri House and Senate. 
   It now awaits the Governor's signature to become law. 
      The lead sponsors in the House (Rep. Scharnhorst, Grill, Grisamore) all expressed their support to countless other legislators who made this piece of legislation possible.  After much discussion of the components of the conference committee sub, it was accepted and then it was approved overwhelmingly 144-16. 

    In the Senate, lead sponsor Senator Scott Rupp quickly took the House-approved version to the floor for final passage, thanking the many who had helped on that side of the capitol.  With his family in attendance, Senator Eric Schmitt received a standing ovation from his fellow senators and the gallery after sharing his touching reflections on having a child with autism.  Senator Days also complimented and congratulated everyone on this accomplishment, while admonishing the insurance industry for making families have to come to the legislature and "beg to get what they already pay for".
The bill passed in the Senate with a vote of 27-6. 

THE BUZZ: 
The components of the bill listed below are seemingly VERY good news compared to where we have been with changes to language during the session. The bill will become effective Jan 1, 2011. Once the bill becomes available - perhaps as early as tomorrow- we will double-check the following and post any corrections if needed.
However, our understanding of what the legislation contains:

     An official and precise interpretation of the statute will most likely be available from the state of Missouri soon.  But until then ...We believe provisional licensure for behavior analysts will be required between 2011-2012. Licensure will then be required beginning Jan 1, 2012.
   The licensure for behavior analysis constitutes a "practice act", which means that the language essentially defines the practice of ABA in Missouri. It does NOT mean that you only have to have a license if you are billing insurance for ABA.  Therefore it applies to anyone who is practicing behavior analysis (with an exemption for public school staff implementing IDEA and 504 Plans, and students doing ABA practicums).

Check the website for the actual bill specifics - when it is released, we will post!

May 11, 2010:  Jefferson City
PROGRESS

Autism Bill progress - Conferees appointed in the House

The House conferees were officially appointed (read on the Hosue floor) moments ago. The Senate conferees were appointed last night.
A compromise version should emerge soon, it will then need one last final approval by both the House and the Senate.
       House conferees:   Scharnhorst, Nance Cooper (Republicans)
                                      Levota, Grill  (Democrats)
      Senate conferees:  Rupp, Schmitt, Crowell  (Republicans)
                                     Days, McKenna  (Democrats)

We will try to keep language updated on the website to keep you informed of the final details.
Thank you to all who have advocated so strongly to get us to this point!

May 4, 2010:  Jefferson City
Autism insurance legislation ... Will it cross the finish line?

This week brings us closer to the final days of the 2010 legislative session, and with only two weeks remaining, the autism community is closely watching the House to see what they will do with the autism insurance bill.  The good news is that both bills have seen movement, even though action has slowed this second half of the legislative session. 
     Many state leaders have openly supported and even publicly promised autism insurance legislation this session, including Governor Nixon and the Speaker of the House, Ron Richard (R-Joplin), who vowed the bill would be among the first passed this session - yet a final compromise has yet to surface. 
     The House autism insurance bill (HB 1311/1341) was the first to cross over, but it languishes in a Senate Fiscal Oversight committee.  The Senate bill is the most likely vehicle, and with the House committee sub emerging last week, the stage is set for it to come to the House floor and the details to be worked out just in time.But the Senate bill has not retained many of the original provisions, since the House substitute brought down the scope of the bill with lower annual dollar caps and age limits.  The House version also contains extraneous language on mandatory licensure and registration of ABA providers which the Senate does not wish to include. 

THE BUZZ:   
The Senate bill is expected to pass overwhelmingly ... if it has a chance to get to the House floor for a final vote.  But as the legislative clock ticks, the time for a conference committee to work out any language differences has all but passed. 
The Senate most likely will be put in a "take-it-or-leave-it" position, with any version the House may pass. 
The influential insurance lobby may just be counting on the ticking clock by delaying and preventing efforts to work out a compromise solution between the chambers.

There is enough time to finish if legislators decide to make this a high priority.  We can only hope they all put their noses to the grindstone and the tactics of the insurance lobby aside, and push to finalize autism insurance legislation. 
Only time will tell, and time is up in two weeks.

WHAT YOU CAN DO ...
Call YOUR state representative and senator and let them know that they have a constituent that is still watching the autism insurance legislation closely.  Ask them to contact you to let you know how the bills are resolved.
 

Legislative Update
March 18, 2010:  Jefferson City

ONE STEP CLOSER!  Missouri Senate finally passed autism insurance bill this week, after the bill had spent over a month in the Senate Fiscal oversight committee.  It was voted out Thursday morning and then taken to the Senate floor for the third read and final vote.  After much discussion of cost and state budget woes from dissenters, the floor was given to Senator Rupp, the bill sponsor, who passionately summed up the purpose and the increasing need for autism insurance reform immediately.  Senator Rupp eloquently elaborated on the demands of autism on Missouri - on the families, on the school systems, on the state of Missouri - and the noteable absence of the insurance industry to "become the fourth leg of the stool" in helping bring necessary autism treatments to those affected.  The bill passed 26 to 6, and now heads to the House. We expect that the Senate bill (SB 618) will take a similar path as the House autism insurance bill did earlier in the session.  The House bill is now in the Senate, and has been referred to committee, but most expect the Senate bill to be the main vehicle.

Legislative Update
February 16, 2010:  Jefferson City

Autism insurance reform moving ...
HOUSE BILL to finally come to floor for debate!

He may be "Just a bill ... "  but he is MOVING!  The old song tells the story ... it is a long process for a bill to become a law.  The good news is the autism insurance bills are alive and somewhat at the forefront lately!!!

The HOUSE bill is expected to be debated today, Tuesday, Feb 16, on the House floor.  This will be the first time that an autism insurance bill has made it to the House floor for debate. 

In committee, the two House autism insurance bills were "combined", or rather, a substitute bill was offered.  The House bill, while seemingly battered, scarred, and weakened in its language after coming out of its first committee, still has life left in it. 

The SENATE bill has been perfected, which means the language has been finalized, and it has passed its first floor vote.  It is now in another committee, Government Accountability and Fiscal Oversight, and must pass through an approval vote there before heading back to the Senate floor for a final vote.

To listen in on the floor debate, go the MO House of Rep website.  (Morning session starts at 10:00 am.) 



THE BUZZ:   
If in fact the autism bill is debated on the house floor this week, most expect it to pass, but the specifics of the language probably won't be too pleasing to the autism community, as we have seen this bill being changed and altered in committee. 
But we are continually reminded that "Nothing is final until it is final!"  The Senate version has retained much of its original language, and the Senate has seemed much more friendly in general to adding autism insurance coverage. 
As with most bills, if they are lucky enough to make it that far, they will probably end up in a conference committee to hash out the differences in the end.  


Visit the Missouri Autism Coalition website for a listing of bills and sponsors!(written by G.K. Luetkemeyer, an "autism mom" at the Capitol)
 

Legislative Update
January 15, 2010:  Jefferson City

2010 Legislative Session off and running ...
autism insurance reform at top of list


 The 2010 session of the General Assembly kicked off last week, with budget concerns and ethics reform the highlight of the many speeches given.  As work begins, autism is being included in the first flurry of activity.  Of high interest are the three autism insurance bill currently filed - two in House, with multiple co-sponsors and one in Senate.
     -  HB 1311 - Scharnhorst (R)
     -  HB 1341 - Grill (D)
     -  SB 618 - Rupp (R) & Schmitt (R)

All three bills have been referred to committee, and these bills will be among the first bills heard next week.  Hearings are already scheduled:
      - Tuesday, January 19
         12:00 noon in House    &   2:00 pm in Senate

Hearings are open to the public, and while everyone that attends does not always get to speak, written testimony is always welcome.  For more info on the bills, the proposed coverage, co-sponsors, or hearing updates, visit :  The Autism Buzz

With the Governor repeatedly calling for the passage and the Speaker of the House having promised to get autism insurance legislation out early this session, many expect results in 2010.  Yet, there are reportedly some Republicans that are opposed to "mandates of any kind" and are seemingly cautious due to claims of high costs.

The autism community has their work cut out for them to contact and educate their legislators about this legislation.  As was stated by Missouri's Director of Insurance in the autism interim hearings:
 "This legislation is affordable, accessible, and enforceable. "


BACKGROUND:  Last year's efforts saw an autism insurance bill pass the Senate, but no action was taken in the House.  During the interim, the House convened an interim committee which held public hearings at three locations across the state.  That committee heard testimony on autism insurance coverage and education issues.


THE BUZZ:   
An autism insurance bill is expected to make it to the House floor early this year, but with some changes.  The House committee hearing the bill this week was NOT a committee that had previously heard any autism bills, and is not necessarily considered autism-friendly.  But with the Speaker's promise of action, a version is expected to pass - the specifics not yet known. 


Visit the Missouri Autism Coalition website for a listing of bills and sponsors!(written by G.K. Luetkemeyer, an "autism mom" at the Capitol)