MA House Passes Bill Requiring Insurance Companies to Cover Services for Children with Autism

The Massachusetts House has passed a bill requiring insurance companies to cover services for children with autism. These covered services would include ABA (Applied Behavioral Analysis). This is not yet law, though, because the Senate will need to pass its version of the bill, and differences between the two versions will need to be hashed out, and then the Governor would need to sign it into law, so it still has a way to go.

Insurance companies, of course, oppose this bill. They claim it will only increase the cost of insurance coverage. Using that reasoning, though, why not just eliminate all health coverage? Isn’t autism a health-related issue? If not, then what is it? I used to work for an insurance company, and I can tell you that they almost universally oppose any type of mandated coverage. Back when President Clinton was trying to get universal health coverage passed, I recall the insurance company I worked for convening meetings of all company employees (thousands), strongly requesting that all employees write to their Senators and Representatives opposing such health coverage.

Insurance companies claim the cost of covering autism will increase annual costs by somewhere between $14 and $30 per insured. Advocates of the bill claim the annual cost would only be about $10 per year. Either way, I believe that this change is a good change, properly recognizing that autism is a health issue, and that all families regardless of income should be able to treat this disorder.

The bill is far from perfect, but it is better than nothing. Some of the problematic aspects of the bill are:

1. Insurance companies will be able to drop autism coverage for three years if the company’s overall insurance costs rise by more than 1% a year. To me, that seems to give insurance companies incentive to be very liberal with their coverage during the first year, for the sole purpose of being exempted from coverage for the next three years.

2. Insurance companies will be exempt from paying for in school services. I foresee strong battles developing among insurance companies, schools, and parents. Insurance companies will be claiming that various services are appropriate only for schools to administer; schools will be claiming that those same services are not really education related, and should be covered by health insurance companies; parents will be caught in the middle fighting both schools and insurance companies.

3. Small to medium-sized companies that offer health insurance to their employees would be disproportionately affected by this new mandate, because large companies are not subject to such insurance mandates.

By the way, to see a report created by my daughter regarding autism, check out this video: http://www.lawbaron.com/michs-messages.html

Please visit my web site for more information about the Law Office of James M. Baron: http://www.lawbaron.com

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