Autism coverage mandate goes to Kansas governor

Advocates for children with autism won a breakthrough Wednesday when the Kansas Senate approved a bill mandating insurance coverage for the developmental brain disorder.

The Senate voted 38-2 to pass the bill and send it to Republican Gov. Sam Brownback for his signature.

A spokesman declined to say whether Brownback would sign the bill, but the governor’s mansion was lit in blue Wednesday night to commemorate World Autism Day.

Senate passage of the bill culminated a roughly six-year struggle by advocates for children with autism to get Kansas lawmakers to pass the mandate. If signed, Kansas would become the 34th state to require autism coverage.

Although the bill will only help an estimated 750 Kansas children out of more than 8,000 with autism, supporters were overjoyed by the bill’s passage.

“We’re very excited,” said Mike Wasmer, a national advocate for the group Autism Speaks. “It is not perfect. There are some flaws. But it is clearly a step in the right direction. It’s going to help a lot of kids.”

Lawmakers limited the scope of the bill because the federal Affordable Care Act would have required the state to pay for any new mandate added to health plans sold under the law.

That would have driven up the cost so much that it would have been politically difficult to pass the Legislature.

The bill passed Wednesday changed dramatically from what was introduced last month. Advocates for children with autism criticized the original bill, saying it didn’t go far enough to provide coverage.

It now only applies to children under 12. The legislation originally would have promised coverage for anyone under 18.

But the measure requires coverage of up to 1,300 hours a year for a key therapy called applied behavior analysis for children up to 6 years old. The coverage mandate would eventually drop to 520 hours a year after a child had undergone four years of therapy.

The bill also would require 520 hours a year for any child from age 6 up to 12 years old.

The bill doesn’t limit coverage for age and hours of treatment for other autism services.

The new mandate would apply initially only to insurance plans offered before the Affordable Care Act was enacted in 2010 and only to businesses with more than 50 employees. The bill expands in 2016 to cover health plans for small employers and individuals.

Wasmer and lawmakers warned of potential pitfalls, especially part of the bill requiring anyone providing applied behavior analysis therapy to be licensed by the state starting in July 2016.

Democratic Sen. Laura Kellly of Topeka supported the bill but cautioned that licensing presents a “huge problem.” She said it could potentially eliminate providers from offering the service and leave geographic gaps in coverage.

“It’s a better-than-nothing bill,” Kelly said.

State Rep. John Rubin, a Shawnee Republican, negotiated the bill with the insurance industry, which agreed not to fight the measure.

He is still worried about the impact of licensing standards but said there needed to avert a fight with insurance executives.

“We may take another look at the licensure provisions next year,” Rubin said.

This story was originally published April 2, 2014 at 9:30 PM with the headline "Autism coverage mandate goes to Kansas governor."