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Alabama Governor signs autism insurance reform bill

May 23, 2017

Autism Speaks joins the Autism Society of Alabama in applauding Governor Kay Ivey for signing into law House Bill 284, which requires certain health benefit plans to cover medically necessary treatment for autism, including applied behavior analysis (ABA).  Governor Ivey signed HB 284 on Friday, May 19, 2017, making Alabama the 46th state to require meaningful coverage for the treatment of autism. 

Sponsored by Representative Jim Patterson and Senator Tom Whatley, the bill faced strong opposition from powerful insurance and business lobbies in Alabama, but a well-organized grassroots effort on behalf of families impacted by autism prevailed.  HB 284 passed the House 100-0 and then passed the Senate  33-1.  “The grassroots advocacy and perseverance demonstrated by families affected by autism in Alabama has been truly inspirational and was key to passage of this bill,” said Mike Wasmer, Director of State Government Affairs for Autism Speaks. “HB 284 is a very good bill and is a huge step in the right direction for thousands of families impacted by autism in Alabama.”

Despite strong opposition to age caps from families and legislative champions such as Senator Cam Ward, the Senate voted 19-13 to impose an age cap on coverage of 18 years.  The Senate also voted to exclude coverage for small group plans (i.e., small businesses that provide fully insured plans with fewer than 51 employees). 

“The Autism Society of Alabama and Autism Speaks remain committed to working together until all Alabamians affected by autism have access to medically necessary treatment,” said Bama Hager, Policy Advisor for the Autism Society of Alabama.  Many states have passed less than ideal autism insurance laws where advocates have returned in later sessions and succeeded in improving upon terms of coverage.  “Autism does not go away at age 18,” said Hager.  “Our families will continue to advocate for meaningful coverage across the lifespan.”

The final version of HB 284 applies to fully insured large group plans and state employees (i.e., plans administered by PEEHIB and SEIB) and requires coverage for ABA with tiered annual dollar caps based on the age of the insured:  $40,000/year (age 0-9 years); $30,000/year (age 10-13 years); and $20,000/year (age 14-18 years).  Coverage for treatments such as speech therapy, occupational therapy, physical therapy, and psychological and psychiatric care is unlimited.  HB 284 also reiterates Alabama’s obligation under Federal law to provide medically necessary treatment for autism under the EPSDT benefit of Medicaid. 

Autism Speaks estimates that the terms of coverage in HB 284 will apply to nearly 1 million Alabamians.