Autism insurance coverage advances

Advocate staff photo by Travis Spradling State Rep. Franklin J. Foil, R-Baton Rouge, greets Baton Rouge’s Shelley Hendrix, director of grass roots development for the national organization Autism Speaks, shortly after the full Louisiana House approved legislation Tuesday that would result in more insurance coverage to help treat autism. Hendrix was on the phone with her group’s New York City office to pass on the news.

by marsha shuler

Capitol news bureau

More children with autism spectrum disorders would be able to get health insurance coverage under legislation that sailed through the Louisiana House on Tuesday.

The House voted 96-0 for the legislation and gave bill sponsor state Rep. Franklin Foil, R-Baton Rouge, a round of applause after the vote. Seventy state representatives joined as coauthors of the House Bill 771. Autism is described by medical websites as a nervous system development disorder distinguished by repetitive behavior and problems with communicating and interacting with other people.

Foil’s measure would expand the mandatory coverage in current law for coverage of diagnosis and treatment of autism spectrum disorders. He said he is trying to provide some additional relief to parents faced with the cost of expensive therapies and children in need of care.

HB771 would raise from age 17 to age 21 the age for mandatory coverage and eliminate a lifetime maximum benefit of $144,000. The legislation would also extend the mandatory coverage to any plan issued to an employer with 50 or fewer employees. The new requirements would go into effect Jan. 1, 2014.

Foil said the current mandated coverage had been estimated to increase policy costs by $1.25 per month. The actual cost turned out to be 29 cents per month. He said the expanded coverage would add only 2 cents a month.

The legislation would not affect individual plans, he said.

The state Office of Group Benefits, which handles insurance for state government workers, paid $773,304 for 299 claims in 2011 for the current autism treatment, according to the Legislative Fiscal Office. The average claim in 2011 was $2,586, the fiscal office stated.

HB771 now moves to the state Senate for debate.

As a freshman legislator, Foil sponsored and successfully pushed legislation to require health insurers in Louisiana to provide medical coverage for children with autism. Act 648 of the 2008 session provides for the mandated health insurance coverage of Applied Behavior Analysis for children up to age 17, a lifetime maximum of $144,000 and excludes small businesses with fewer than 50 individuals.