Legislature(2011 - 2012)BUTROVICH 205
03/30/2011 01:30 PM Senate HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SCR7 | |
| SB22 | |
| SB74 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SCR 7 | TELECONFERENCED | |
| *+ | SB 22 | TELECONFERENCED | |
| *+ | SB 74 | TELECONFERENCED | |
| + | TELECONFERENCED |
SB 74-INS. COVERAGE: AUTISM SPECTRUM DISORDER
CHAIR DAVIS announced the next order of business would be SB 74,
relating to insurance coverage for autism spectrum disorders.
2:20:22 PM
SENATOR JOHNNY ELLIS, sponsor of SB 74, thanked the committee
for hearing the bill. He said autism is a devastating disorder
affecting one in 110 American children. Despite being treatable,
most children with autism spectrum disorders never receive the
treatment they need. SB 24 would require insurance companies to
cover treatment for autism spectrum disorders (ASDs), including
medically necessary applied behavior analysis (ABA). Most
insurance policies specifically exclude coverage for treating
autism. A total of 35 states and the District of Columbia have
laws related to this issue, and at least 23 specifically require
insurance companies to provide coverage for the treatment of
autism.
According to the governor's council on disabilities and special
education, insurance coverage of treatment of ASDs would save
the state $280,500 per capita in avoided special education
costs, with a lifetime savings of $1.8 million per child.
2:22:37 PM
The majority of children with autism who receive appropriate
intervention and treatment experience remarkable improvement.
Early intervention and treatment work. Forty-seven percent of
those treated recover typical function; forty percent make
significant improvement, while the remaining thirteen percent
make little progress. Treatment can save the state millions and
significantly improve the lives of thousands. Families feel like
they are drowning without assistance.
2:23:50 PM
AMORY LELAKE, staff to Senator Ellis, said she would walk the
committee through the bill. Section one amends AS 21.42 by
creating a new section, AS 21.42.397 relating to insurance
coverage for autism spectrum disorders. Subsection (a), page 1
line 1 through page 2, line 12, requires insurance plans to
cover medically necessary treatment for autism disorders.
Subsection (b), page 2 lines 13-23, further defines the coverage
that must be provided.
Subsection (c), page 2 lines 24 and 25, establishes that this
section does not limit coverage already provided. Subsection
(d), page 2 lines 26-28, prohibits an insurance company from
denying coverage to someone because they have an autism spectrum
disorder. Subsection (e), page 2, line 29 through page 3 line 21
defines "autism service provider," "autism spectrum disorders,"
"health care insurance plan," "health care insurance," and
"medically necessary."
Section 2 page 3 lines 22-26 establishes that the provisions of
section 1 only apply to insurance policies issued after January
1, 2012. Section 3, page 3 lines 27 establishes an immediate
effective date for this act.
2:25:58 PM
MS. LELAKE stated there were numerous experts on line who could
speak to the legislation.
LAURIE EUNAM, attorney and parent of a 10-year-old son with
autism, said she was testifying in support of SB 74. She is also
senior litigation council with Autism Speaks, a New York-based
non-profit. Her full-time job is to advocate for autism
insurance reform in all 50 states. Autism is a medical condition
brought on by no fault of the family. In slide #2, the graph
shows distinct diagnoses within the disorder; Autistic Disorder,
Asperberger's Syndrome, and Pervasive Developmental Disorder.
The most severe diagnosis is Autistic Disorder. Pervasive
Developmental Disorder Not Otherwise Specified (PDDNOS) is a
mild form of autism spectrum disorder. It accounts for one-half
of all diagnoses.
There is no known cure for autism but it can be treated so that
symptoms are not disabling. The most commonly prescribed
treatment protocol is Applied Behavior Analysis (ABA) which has
been used for many years to treat autism, but the insurance
industry continues to deny coverage for this treatment. The
Surgeon General, the National Research Council and the American
Academy of Pediatrics all have endorsed the use of ABA therapy
for children with autism.
2:30:32 PM
Studies show that if ABA is administered intensively by properly
trained therapists, about half of the treated children will
overcome their autistic characteristics such that they can enter
first grade indistinguishable from their peers. The therapy must
be administered intensively, often 20, 30, or even 40 hours per
week. Her son's autism is severe and his therapy costs out of
pocket $75,000 per year. She and her husband have made
sacrifices, such as selling their home and moving to a cheaper
one, to afford therapy for their son. But how many families have
that kind of money to sacrifice? Most don't, and so children go
untreated.
We know there is a treatment that works but children can't get
the treatment they need. These are families who are doing the
right thing by buying insurance, and still can't get the help
their children need. Only the wealthy few get treatment. Autism
prevalence is on the rise. Over the past 25 years it has gone
from one in 2,500 to one in 110. A huge autism tsunami is
coming. Without private insurance, the needed treatment will not
happen.
2:34:02 PM
Twenty-four states have mandated autism insurance coverage. One
state has passed a bill in 2011, and West Virginia's bill is
about to become law. Actual claims data from Blue Cross Blue
Shield (BCBS) of Minnesota, where the law has been in effect
since 2001, shows that the financial impact for covering autism
is .83 per member per month. In South Carolina the state
employee health plan has released this cost data: the statute
passed in 2007 and took effect in 2009. It caps coverage for ABA
therapy at $50,000 per year at age 16. In 2010 the increase was
.44 per member per month. The law has minimal impact on premiums
and its overall impact on the economy has been positive. People
have been trained and are working full-time as therapists for
children with autism.
2:38:55 PM
SENATOR DYSON asked is it logical to assume that in a state like
Alaska with a very small population, the cost per policy would
be higher.
MS. EUNAM answered if that was typically the case, then probably
yes.
SENATOR DYSON said it would seem that if South Carolina has a
cost of .44 cents per month with around five million people,
compared to Alaska with only 700,000 people, the cost per policy
holder would be higher.
MS. EUNAM said she would let the actuary speak in more detail
about that. Cost projections from state to state have not varied
dramatically, and she was not aware of any factors specific to
Alaska.
2:41:31 PM
MARK LAMBRIGHT, Independent Actuary, Oliver Wyman, said he would
address the previous question. In doing the actuarial studies,
they did consider that medical costs are higher in Alaska.
However, due to fewer people being covered, the overall costs
would be lower. The costs per member would be roughly the same.
Analysis indicates that premiums would increase .3 to .7
percent. The net result is an estimate of cost increase. Other
independent actuaries have provided similar analyses.
2:45:04 PM
MARGARET COSSLER, Anchorage, said she was speaking on behalf of
her five year old son with autism. She and her husband wanted to
find the best possible treatment for their child. Not having
insurance to cover this is extremely stressful for the family;
knowing that there is something you can do to help your child
but you cannot provide it is extremely painful and nearly
unbearable.
2:47:05 PM
SENATOR ELLIS noted that Representative Petersen had joined the
meeting.
2:47:37 PM
JANICE GERTON, mother of Chad Gerton, testified on her own
behalf. He was diagnosed as Autistic at age 5. At 12 his
diagnosis changed from Autism to Asperberger's Syndrome. At 18
months they knew he was not the same as their other children.
Each doctor they saw said he did need speech therapy,
occupational therapy, sensory integration. When he started
school they gave him an IEP and they did what they could. He
never lost language but had many issues with peers. His
experiences were hard for the family and hard for him. Her job
became 24 hours trying to find services. The family had good
insurance but it did not cover what he needed.
Early intervention has been proven the best way. There would
have been less impact in his life and life of his family. He
needed this in school, home, and community. One out of 110 kids
is affected. Four out of five are boys. Intervention should have
come early, but it was very slow. Early intervention works.
Fewer services are needed over a lifetime. Her son became an
Eagle Scout, his senior class treasurer, and has become an
accountant. At age 25, he was recently married. He is working
full time and taking 12 credits at UAS. Children with autism
need a good health plan.
2:52:13 PM
This should be in place for the next generation so they can
receive early intervention and have the best possible quality of
life. Her son still has issues because he lacked the right type
of services early on. The month of April is Autism Awareness
Month; they are trying to get people to understand and accept
the differences.
2:53:33 PM
CHAIR DAVIS thanked the witness for coming forward.
LAURIE KING, mother of a 20 year old daughter with autism, said
her family didn't have the insurance they needed to take her to
the specialists at an early age. They had insurance but it
didn't cover what they needed. Her husband was diagnosed with MS
and unable to work, so she had to work instead of taking care of
her daughter. She said her daughter would have done much better
with earlier intervention. They could not get services for her
until age eight; as a result, her potential to be a functioning
member of society was severely degraded.
2:59:59 PM
CHAIR DAVIS said the committee had heard good testimony on the
bill today. She also had several letters and emails of support.
BCBS of Alaska is in opposition.
3:00:57 PM
CHAIR DAVIS invited Representative Petersen to testify.
REPRESENTATIVE PETE PETERSEN said when you hear the stories it
is hard to believe the lack of coverage still continues.
Children are missing their window of opportunity to have a
normal life.
CHAIR DAVIS asked for a motion to move the bill.
SENATOR DYSON said he had some remarks but given the time
constraints he would not speak.
CHAIR DAVIS asked why not a short version.
3:03:02 PM
SENATOR DYSON said he applauds the purpose of the bill. What
troubles him is the funding source. The insurance companies are
not the problem. When we get down to figuring out how we serve a
good purpose, he worries that we choose pragmatism at the
expense of freedom. He agrees that services for children with
autism need to be available. The righteous way would be to pay
for it out of the general fund so that everyone has the same
chance. There is a fairer way to get services to children, and
that is to do it through the tax base. Putting the burden on
insurance companies is easier, but he worries about the
direction we are going.
3:06:42 PM
He also questioned having a zero fiscal note. Maybe it doesn't
come out of the state's pocket, but it will come out of state
employees' pockets. He does applaud the intentions of the bill
and his heart goes out to the kids.
3:07:37 PM
CHAIR DAVIS said this bill has another committee of referral and
some of those issues will be heard there.
SENATOR EGAN moved to report SB 74 from committee with
individual recommendations and attached fiscal note(s). There
being no objection, SB 74 moved from the Senate Health and
Social Services Standing Committee.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SCR 7 Sponsor Statement.pdf |
SHSS 3/30/2011 1:30:00 PM |
|
| SCR 7 Bill Text.pdf |
SHSS 3/30/2011 1:30:00 PM |
|
| SCR7 10 Things You Should Know About FAS.pdf |
SHSS 3/30/2011 1:30:00 PM |
|
| SCR7 FASD Economic Cost pgs 34-37.pdf |
SHSS 3/30/2011 1:30:00 PM |
|
| SB 22_Version A.pdf |
SHSS 3/30/2011 1:30:00 PM |
SB 22 |
| SB 22 Sectional Analysis Version A.pdf |
SHSS 3/30/2011 1:30:00 PM |
SB 22 |
| SB22 CS Version B.pdf |
SHSS 3/30/2011 1:30:00 PM |
SB 22 |
| SB 22 Summary of Changes Version B.pdf |
SHSS 3/30/2011 1:30:00 PM |
SB 22 |
| SB 22 Youth Concussion Ed Pack.pdf |
SHSS 3/30/2011 1:30:00 PM |
SB 22 |
| SB 22 State Legislatures Article.pdf |
SHSS 3/30/2011 1:30:00 PM |
SB 22 |
| SB 22 NPR Story.pdf |
SHSS 3/30/2011 1:30:00 PM |
SB 22 |
| SB 22 LetterOfSupport ABIN.pdf |
SHSS 3/30/2011 1:30:00 PM |
SB 22 |
| SB 22 Brain Injury Association of WA.pdf |
SHSS 3/30/2011 1:30:00 PM |
SB 22 |
| SB 22 Boston Univ Article.pdf |
SHSS 3/30/2011 1:30:00 PM |
SB 22 |
| SB 22 AATA Letter of Support.pdf |
SHSS 3/30/2011 1:30:00 PM |
SB 22 |
| SB 74 Bill.pdf |
SHSS 3/30/2011 1:30:00 PM |
SB 74 |
| SB 74 Sectional Analysis.pdf |
SHSS 3/30/2011 1:30:00 PM |
SB 74 |
| AK HB 79- SB 74 Actuarial Cost Analysis 3 4 2011 FINAL.pdf |
SHSS 3/30/2011 1:30:00 PM |
HB 79 SB 74 |
| SB 74 Autism Plan Progress.pdf |
SHSS 3/30/2011 1:30:00 PM |
SB 74 |
| SB74 Breaking Through.pdf |
SHSS 3/30/2011 1:30:00 PM |
SB 74 |
| SB74 Ganz Article on Societal Costs.pdf |
SHSS 3/30/2011 1:30:00 PM |
SB 74 |
| SB74 Stone Soup Group.pdf |
SHSS 3/30/2011 1:30:00 PM |
SB 74 |
| SB74 Trust Letter.pdf |
SHSS 3/30/2011 1:30:00 PM |
SB 74 |