Sunday, June 17, 2007

Texas Governor Signs Autism Insurance Bill

Without fanfare, Texas Gov. Rick Perry signed a bill to amend the state insurance code to require some health plans to cover autism-related services for children older than 2 and younger than 6 years old. The Houston Chronicle cited Perry's signing the bill (House Bill, or H.B. 1919) in a story posted June 16 which summarized a number of the governor's legislative actions. (See story here.) The governor's website confirms Perry signed the bill, which includes other issues related to health insurance for individuals with brain injuries. Perry's office has not yet posted a statement about why he signed the bill, in spite of a powerful business lobby's opposition. (Read more background here.)

You can read text of the bill, H.B. 1919, via the Texas Legislature website, by clicking here. The new law takes effect September 1, 2007 and spells out what kinds of autism-related services must be covered, including evaluation and assessment services; applied behavior analysis; behavior training and behavior management; speech therapy; occupational therapy; physical therapy; and medications and nutritional supplements "used to address symptoms of autism spectrum disorder."

With the passage of new insurance laws in Texas and South Carolina, I've updated a map of what state legislation around the United States says about autism-related services. See the map below on this blog, here or here.

10 comments:

madfis said...

We need to move Autism out of the "mental health" category and put it in the medical catogory in order to get complete and life long coverage. Mental health is offen only treated by psychiatrists and psychologists and ASD needs to be treated by speech therapists, OT, neuroligists, GI specialists, etc. Unfortunately in western medicine the mind and the body are not considered one; which is why there are different policies for "mental health" and "medical health". ASD is a perfect example of a disorder that is compreshensive across mind and body.

irene said...

Thank you for consistently posting thorough updates. They are always very helpful.

Michael Goldberg said...

Madfis thanks for raising that interesting point. And Irene: I appreciate your feedback. thank you.
Michael

Martin J. Cirkiel said...

My name is Martin Cirkiel, and have been asked by the local Community MHMR to speak about HB1919. I was looking at the bill and became concerned about the following section:

"SECTION 9. This Act applies only to a health benefit plan delivered, issued for delivery, or renewed on or after January 1, 2008. A health benefit plan delivered, issued for delivery, or renewed before January 1, 2008, is governed by the law as it existed
immediately before the effective date of this Act, and that law is
continued in effect for that purpose."

To your understanding, what does this section mean? What are its implications?

Michael Goldberg said...

Martin
I'm not a lawyer or insurance consultant or a Texas legislative expert, but it reads as if the Texas legislature wanted to give insurers some time to implement this; that is, it reads to me to say that plans it applies to plans that are new or renewed as of Jan 1, 2008. If a plan was renewed for a year on Dec. 31, 2007 for a year or more, a patient would have to wait until it was renewed. That's how I read it, I am interested to see comments from others who may know more.
Michael

Anonymous said...

Michael,

I'm researching for a project at the University of North Texas and I have a question about amendment 1.

Where it says that on page five to strike lines 1-5 and substitute with (1) Speech therapy; (2) OT; (3) PT; (4)medicines and nutritional supplements used to address symptoms of ASD, does that mean they cut out coverage of ABA? I understand you're not a lawyer, but I thought you might have a better understanding of it than I do.
Thanks!
Caroline

Michael Goldberg said...

Hi Caroline
You should consider checking with a sponsor of the original bill, or the legislature's health committee staff to find out about the legal meaning of this law in Texas. Good luck with your research project. I hope you will consider sharing the results with me.
Michael

Wendy said...

My son is 18. I live in Florida and can't find insurance for him. Will the new proposals cover him? Even kids with autism grow up.
Wendy Bleakley

Anonymous said...

Hi! I noticed that the Texas bill 1919 only ensures coverage for children ages 2-6. I feel like I've read somewhere that coverage is ensured for ages 5 to 21. Is this incorrect or is this another bill in the works? Also, does this bill apply only to insurance companies that are based in Texas? Or, are all insurance providers subject to this law if the person that they are covering is receiving services in Texas? Any help would be greatly appreciated!

Anonymous said...

What is our government thinking? If these children are not treated we all will incur the cost of their support in years to come. By treating these children they have the potential of becoming adults who can care for themselves and become functioning citizens of this country. Without treatment like ABA they will surely need to be supported by us all in the future.

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