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FOR IMMEDIATE RELEASE |
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State
Rep. Barb McIlvaine Smith
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Senate amended autism bill not good enough for parents waiting for help
HARRISBURG, June 30 – A bill (H.B. 1150) to require health insurance companies to provide coverage for diagnosis and treatment of autism spectrum disorder passed in the Senate Sunday night, but state Rep. Barb McIlvaine Smith said the bill was amended in such a way that it would give insurance companies a way out of covering autism.
"The Senate version of House Bill 1150 would allow insurance companies to define what is 'medically necessary' in terms of autism treatments, rather than letting that determination be made by the medical professionals trying to help a child diagnosed with ASD," McIlvaine Smith said. "Researchers are making amazing strides in the treatment of ASD, but what good are these miracles if parents can't afford them?"
Currently, insurers do not have to cover autism. There is no cure for autism and much of the treatment involves behavioral therapy, which insurance companies argue isn't medical care.
McIlvaine Smith said H.B. 1150 was introduced by House Speaker Dennis O'Brien and received bipartisan support. It would require insurance companies to cover up to $36,000 of autism-related treatment for people under 21. The House passed the bill unanimously last July and sent it to the Senate for consideration.
Coverage under H.B. 1150 would include medically necessary diagnostic assessments, evaluations or tests, psychiatric and psychological care, rehabilitative care, and therapeutic care to include speech, occupational or physical therapy services, and prescription drugs.
Health insurers and business groups have opposed the bill, saying it would result in an expensive insurance mandate that harms businesses, especially small ones.
However, McIlvaine Smith noted that a study by the Pennsylvania Health Care Cost Containment Council, commissioned after last year's House passage of the bill, concluded that covering autism would raise premiums by 1 percent. PHC4 called that increase "modest," noting that insurers predict premiums will rise 8.7 percent this year even without autism coverage.
"Helping children with autism to reach their fullest potential is the right thing to do for the children, their families and all of society," McIlvaine Smith said. "Early intervention and providing the best treatment and therapy possible will allow these children to reach their fullest potential, helping them to be productive, active members of their communities. We cannot let them down."
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