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Autism Insurance Bill Clears Utah Senate, Moves To House

February 28, 2014

SALT LAKE CITY  (February 28, 2014)  -- The Utah Senate has approved SB.57, the furthest an autism insurance reform bill has progressed in the state Legislature since efforts began in 2009. Utah has the highest prevalence of autism in the nation at 1 in 47, yet is one of of only 16 states not to require private insurers to cover medically necessary treatments.

The vote was 18-7.

"Autism Speaks commends Senator Brian Shiozawa [left] for his leadership in steering this urgently needed legislation through the Utah Senate," said Mike Wasmer, Autism Speaks' associate director of state government affairs. "We join with the Utah Autism Coalition and the state's autism community in urging the House to now do what's right and pass this bill."

Shiozawa's bill would require state-regulated health plans to cover speech, occupational and physical therapy, psychological and psychiatric care, and behavioral health treatments, including applied behavior analysis (ABA). Behavioral health treatment benefits would be capped annually at $36,000 through age 9 and $18,000 from ages 9 through 18.

During debate on the bill Thursday, Shiozawa said autism is "in epidemic proportions, the insurance companies themselves say that autism is in epidemic proportions in the state of Utah. They acknowledge that this is a real condition, they also acknowledge that there is a best therapy for this.

"We're asking that they simply cover this condition," Shiozawa said. By supporting the bill, Shiozawa told his colleagues, "You give the children and their families, the thousands of children in the state of Utah a voice, a voice to be heard by the insurance companies, a voice that says to them we faithfully pay our premiums, please cover our condition."

Shiozawa said he had attempted to craft a workable bill by working with two major Utah insurers.

"I have gone to their offices, I have sat down with them, I have offered that we will do whatever we need to do to negotiate on this, on dates of services, on the ages, on the caps," he said. "Make this your bill, this is your opportunity. And their response is, no, we’re going to fight this and we’re not going to pay for this."

Senator Scott Jenkins of Plain City spoke against the bill, calling it a form of socializing costs. "This is making it a mandate for the insurance companies to cover their insured," he complained.

However, Senator Todd Weiler from Woods Cross said the autism debate had changed his views on insurance after a constituent explained how his son with autism was initially denied coverage for a broken arm.  

"The insurance company denied the bill using as an excuse the child had been diagnosed with autism and that the broken arm most likely was caused because the child was autistic," Weiler said. "That is discrimination. And if that’s how insurance companies are going to treat children in my district, that’s going to change my opinion about insurance mandates."

Senator Deidre Henderson of Spanish Fork said the insurance lobby had indicated that the billing was later resolved after an investigation determined the original denial was the result of a "miscode." She voted against the legislation.

Senator Karen Mayne, a retired para-educator from West Valley City, said when she began her career, no more than one or two children in the school had autism. "When I left we had just about one in every class...This is an epidemic, this is divorce city, this is crisis city and there is only so much energy in a family and it does more than harm the child, it harms the family, it harms society."