Autism treatments will be covered by many insurance companies now that a new law has taken effect.
Not quite a third of the children with autism disorders will be covered by the law approved this past regular session.
State Sen. Jim Lembke (R-St. Louis) says it took two years for the legislation to pass, because it had to overcome resistance to mandates.
“I think that when you’re struggling as a legislator as far as what is the balance of oversight that you have in businesses in your state and things that you mandate, that’s what made it difficult for this bill to pass through the General Assembly,” Lembke says.
But pass it did on the strength of heart-tugging stories of families burdened by a vexing disease and mounting bills.
Sen. Robin Wright-Jones (D-St. Louis) says the General Assembly spoke loudly.
“It sent a signal to the insurance companies that there is a reason why families need to be covered for these types of life-long issues that are digging at their heartstrings and digging in their pockets as well,” Wright-Jones says. “So it was a very compelling and passionate debate. We had to bring it back again and managed to get it through.”
Just shy of a third of Missouri children with autism disorders will be covered by CCS SCS HCS HB 1311 & 1341. The legislation will require that insurance companies licensed by the state provide coverage for the treatment of autism spectrum disorders. It caps the payments for applied behavior analysis at $40,000 per year, indexed to inflation. The legislation exempts MO HealthNet, the state Medicaid program.
Backers of the autism mandate say autism was the only one of the top twelve neurobiological disorders that insurance companies refused to cover. The law does contain a provision that small businesses can ask the insurance department to excuse them from providing autism coverage for employees if their premiums increase substantially. Backers of the legislation say the bill should increase premiums incrementally, about one-fourth of one percent.