Texas Legislature Passes Autism Insurance Reform Bill

AUSTIN – This week, the House passed SB1484 by Sen. Kirk Watson (D-Austin), Sen. Eddie Lucio Jr. (D-Brownsville), and Sen. Wendy Davis (D-Fort Worth), relating to health benefit plan coverage for enrollees diagnosed with autism spectrum disorders (ASD). Rep. Larry Gonzales (R-Round Rock), Rep. Ron Simmons (R-Denton), and Rep. Senfronia Thompson (D-Houston) sponsored SB1484 in the House.

Under current law, health benefit plans only provide coverage to ASD enrollees from the time they are first diagnosed with autism until their 10th birthday. For any child older than the age of 10, it can become extremely difficult, if not impossible, to receive coverage for ASD. SB1484 removes this age restriction within the Insurance Code to ensure continued coverage for ASD beyond age 10.

“Autism is an epidemic in this country,” said State Representative Larry Gonzales. “More children will be diagnosed with autism this year than AIDS, diabetes, and cancer combined. But autism is treatable, with many kids – up to 87% – recovering very well with an early diagnosis and proper treatment. An arbitrary age restriction on provided treatment and services makes no sense.”

“Autism affects 1 in 88 children in this country. And those children aren’t cured at age 10 from autism, even though insurance coverage ends under current law,” said State Representative Ron Simmons. “SB1484 makes a real difference to families who struggle with treatment costs for Autism by lifting this arbitrary age cap – no matter their age. We look forward to Gov. Perry signing this common sense legislation into new law.”

“This is not a new insurance mandate,” added Rep. Gonzales. “Children diagnosed with ASD are already covered by insurance, and have been since 2007. We’re simply removing the arbitrarily set age cap. Autism should be treated as any other childhood disease, such as asthma, which continues to receive coverage well beyond the age of 10.”

During conversations regarding costs to implement SB1484, data showed the added costs to cover ASD past the age of 10 was only 38 cents per member per month in Missouri. In Arizona, Louisiana, and South Carolina, the actual costs were less than 10% of those initially projected.

Coverage past the age of 10 is very common. In the private sector, Home Depot, IBM, Goldman Sachs, Pacific Gas and Electric, Wells Fargo, Capitol One, and the Southern Baptist Convention provide meaningful ASD coverage. And in the public sector, Tricare and the Federal Employee Health Plan provide full coverage for active duty, retired military and federal employees.

On May 1st, SB1484 was received in the House after passing the Senate as amended. With only a few days left of the regular session, the House successfully passed this important piece of insurance reform. Now, SB1484 will proceed to Gov. Rick Perry’s desk, where it awaits his signature in order to become law.

Share this post:

Leave a Reply

You must be logged in to post a comment.

Subscribe to our campaign e-mail updates!