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DC Council Approves Autism Insurance Reform

June 04, 2013

WASHINGTON, DC (June 4, 2013) -- The District of Columbia Council today unanimously approved an insurance reform bill that will require coverage for ABA for autism through small group and individual policies starting next year. Once signed by Washington Mayor Vincent Gray, who requested the bill, the District will join 33 states that have enacted autism insurance reform.

The District Council by voice vote approved changes to its American Health Benefit Exchange that starts operation in 2014 as part of the Affordable Care Act. One of the changes is a requirement that all small group and individual plans cover habilitative services, including "applied behavior analysis for the treatment of autism spectrum disorder."

Small groups are employer health plans with fewer than 50 members.

The change is part of the Better Prices, Better Quality, Better Choices for Health Coverage Act of 2013, which Gray requested the council to approve. The changes, including ABA coverage, were recommended by the District of Columbia Health Benefit Exchange Authority in March.

All individual and new small group health plans will have to operate through the District's new health benefit exchange in 2014. Existing small group plans will be required to provide the Exchange's benefits in 2014, then operate through the Exchange in 2015.

Minnesota last month became the 33rd state to enact autism insurance reform. In addition to the District of Columbia, North Carolina, Oregon and Nebraska are advancing bills that would require coverage of autism therapies.