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Utah autism treatment coverage bill clears first hurdle
Behavioral therapy » SB57 would require insurers to pay for autism therapy.
First Published Feb 14 2014 02:45 pm • Last Updated Feb 14 2014 08:52 pm

Angst over health insurers refusing basic medical care to autistic kids trumped ideology on Friday with a committee’s endorsement of SB57.

SB57 would add Utah to the list of 34 states that require insurers to pay for autism treatment. It cleared the Senate Business and Labor Committee 6-1, despite concerns that it could raise insurance rates for employers, including the state of Utah.

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Fiscal analysts predict the bill would cost the state about $3 million, mostly in increased premiums for state employees.

Sponsoring Sen. Brian Shiozawa, R-Cottonwood Heights, said data from other states with autism coverage requirements show the increases in premiums costs are negligible. A study in Missouri showed its autism mandate bumped the cost of health insurance claims by 0.2 percent.

"There’s a medical adage you never want to be the first or the last to embrace a therapy," said Shiozawa, a physician. But "this is not an investigational drug or therapy. We know this is safe and that it works."

The bill is endorsed by the Salt Lake Chamber of Commerce and Utah’s doctor lobbies, the Utah Medical Association (UMA) and Utah Academy of Family Physicians.

It’s opposed by the equally politically powerful insurance industry, which contends it will raise insurance premiums for small businesses that can least afford to pay them and will likely drop their health benefits. SB57 would only affect state-regulated insurers, those that sell directly to individuals and small employers.

But faced with growing ire over coverage denials, insurers were hard-pressed to mount a persuasive argument Friday.

Utah families spoke of having to dip into retirement savings, sell homes and file bankruptcy to pay for treatment.

"We needed speech and occupational therapy and we were not able to receive that through the insurance that we paid premiums for. We paid for it on our own, which led to us filing bankruptcy," said Nate Passey, the Midvale father of a 6-year-old girl with autism.


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Among the benefits of therapy was hearing "I love you" from their previously nonverbal daughter, he said.

Of particular concern to senators, though, were reports of insurers refusing to cover medical claims unrelated to autism once children are diagnosed.

"It doesn’t make any sense to me when I hear stories about little children who have broken arms and are denied coverage because they have autism. It’s appalling. There’s no excuse for that," said Sen. Deidre Henderson. "I hope industry will work to resolve that problem."

Ideologically opposed to insurance mandates, the Spanish Fork Republican was alone in voting against the bill, but stressed, "It’s a reluctant no."

Sen. John Valentinewas less inclined to trust insurers to change on their own. "I’ve consistently voted against mandates," the Orem Republican said. "However, I am convinced that we need to tell our insurance companies to get on the ball. I’m going to vote for [the bill]."

"Equally dismayed that insurance companies have not solved this problem," Sen. Todd Weiler, R-Woods Cross, lent his support but said he would like to see the bill amended to lower its maximum treatment allowance.

SB57 would require health plans to cover up to $36,000 worth of treatment a year for children through age 8, then up to $18,000 a year through age 17. It heads now to the Senate floor.



Copyright 2014 The Salt Lake Tribune. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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