As introduced: LB 1129 requires health insurance plans sold in Nebraska on or after January 1, 2013 to provide coverage for the screening, diagnosis, and treatment of autism spectrum disorder for children (under age 21).  Providing for some exceptions, coverage will not be subject to any limits on the number of visits and not be subject to dollar limits, deductibles, copayments or coinsurance provisions that are less favorable than equivalent provisions applying to a physical illness.

As Amended: none

Introducing Senator(s): Coash

Committee: Banking, Commerce and Insurance

Committee Hearing Date: January 19, 2012

Current Status: Indefinitely postponed

Estimated Fiscal Impact: Coverage for behavioral health treatment is subject to a maximum benefit of $70,000 per year for children nine years old or under and $20,000 for children over nine years of age, up to age 21.  The Director of Insurance is to adjust the maximum benefit for inflation on an annual basis beginning in January, 2014.  Insurers may request a review of the treatment of a person with autism spectrum disorder not more than once every twelve months and shall pay the cost of such review.

Voices for Children Position: Support

Voices strongly supported LB 1129 because we believe it would increase access to critically necessary services for children who are currently being denied coverage. Currently, treatments for autism are difficult to access, often inadequate, and frequently delayed. When services are delayed or denied to these children, critical windows to intervene are lost. But when provided access to early and intensive interventions, children with autism are shown to have significant improvements in language skills and behavior, raised IQ levels and greater success in school. The efficacy of applied behavioral analysis (ABA), in combination with occupational therapy, speech therapy and physical therapy, has been established repeatedly.

Research:
Pediatrics
US Surgeon General’s Report on Mental Health, 1998
Research in Autism Spectrum Disorders
American Speech-Language-Hearing Association

What other states are doing: The number of states that require health insurance coverage for autism is growing, either through specific or limited coverage requirements or mental health parity. Currently, the states with specific autism mandates are:

• Arizona
• Arkansas
• California
• Colorado
• Connecticut
• Florida
• Illinois
• Indiana
• Iowa
• Kansas
• Kentucky
• Louisiana
• Maine
• Massachusetts
• Missouri
• Montana
• Nevada
• New Hampshire
• New Jersey
• New Mexico
• New York
• Oregon
• Pennsylvania
• South Carolina
• Texas
• Vermont
• Virginia
• West Virginia
• Wisconsin