The state Senate’s top leaders united Thursday behind an effort to make insurance companies cover autism, despite opposition from business and insurance groups who warn it would increase health insurance premiums across Georgia.
Senate Bill 397, introduced only a day earlier, sailed unanimously through committee Thursday after several weeks of behind-the-scene negotiations to craft it. Its provisions are more limited than similar proposals currently pending in the Legislature, which leadership believes gives it a better chance of passage.
“We can’t turn our backs on those who need us the most,” said Lt. Gov. Casey Cagle, who traditionally presides over the Senate as its president and could not recall ever testifying on bills before any committee — until Thursday, when he did in support of this one. “I’ve had a long tradition of opposing mandates, for good reason. But this is an issue that has a good reason. We need to step up and do the right thing.”
Hundreds of advocates have spent at least five years pushing for such coverage, many of them inspired by a now 9-year-old Georgia girl named Ava Bullard. Ava is the great-niece of Sen. Tommie Williams, the chamber's former president pro tem. She began applied behavioral therapy for autism at age 3 and now functions well.
But while previous efforts have tried to impose the coverage mandate broadly, SB 397 among other things would apply only to children 6 years and younger, limit annual payouts to $35,000 and exempt businesses with 10 or fewer employees.
Supporters said those restrictions were a concession to insurance and business groups that oppose the plan. They said the type of therapy envisioned with the mandate is far more important for young children who are not yet school age, meaning they are not covered by an individualized education program mandated by the federal Individuals with Disabilities Education Act.
Research has shown early intervention is key and, supporters say, far cheaper for the state in the long run. Gov. Nathan Deal for the first time recently proposed funding coverage of autism in the State Employee Health Plan. He included $2.5 million for treatment in the fiscal 2015 budget now being vetted by lawmakers.
Still, it puts Cagle, Williams and other conservatives in an unusual position. They adamantly oppose, for example, mandates included in the federal Affordable Care Act. And by pushing this now, they risk the ire of influential groups such as the National Federation of Independent Business and the Georgia Association of Health Plans.
“We oppose government mandates because they increase costs and limit choice,” said Allan Hayes, a lobbyist for America’s Health Insurance Plans. He said the coverage should be optional for both individuals and small businesses: “Let them decide whether they want to cover it or not.”
The bill would not apply to large companies that self-insure employees’ coverage — although many of them, including Home Depot and Georgia Power’s parent, the Southern Co., already provide something similar. It’s also not a new concept nationally.
Thirty-four states mandate private health insurance coverage for autism. Others, including Mississippi and Tennessee, have recently debated it.
"One in 88 children are affected by autism in the country, 1 in 84 in Georgia," said the bill's sponsor, Senate Insurance and Labor Chairman Tim Golden, R-Valdosta. "When the (Centers for Disease Control and Prevention) calls it a public health epidemic, it has to get your attention."
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