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.

The measure  would expand the mandatory coverage in current law for coverage of diagnosis and treatment of autism spectrum disorders.

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.

Comments

1) Comment by Being_Stupid - 02/05/2012

Franklin Foil is your typical RINO that runs on a Republican platform, but once he is in office imposes new bills and laws on business and property owners like a Democrat Socialist. Everytime this RINO Legislature meets, expect another increase in your property taxes and overhead business costs.

2) Comment by Being_Stupid - 02/05/2012

Healthcare cost is expensive because the consumer is not held accountable for the cost. Their employer and employer's insurance is held liable because of Government Programs and Mandates. Medical is the most overpaid profession because of stupid Feel-Good-Legislation like this that forces Employers and Insurance Companies to write blank checks to doctors and pharmacies for overpriced medical treatment. Not only does this drive up the cost on employers, it drives up the cost for overpaid medical treatment on everybody. Get Feel-Good-Government out of the picture, make people purchase their own medical care instead of relying on their employer or some 3rd party, and watch medical costs drop drastically and Private Market Forces take over and restore sanity to the Medical Market.

3) Comment by Being_Stupid - 02/05/2012

Feel Good Legislation = Less Jobs for Louisiana

4) Comment by Being_Stupid - 02/05/2012

So in other words... Make certain if you are a small business owner with about 49 employees, don't hire anymore employees or your healthcare costs will skyrocket.

5) Comment by rosegrahamz - 02/05/2012

Healthcare is not subject to normal market forces! Anything that you have to buy at any random moment in order not to die is not something to which a rational supply/demand calculus can apply. Check out "Penny Health" articles on how to reduce the cost of insurance.