It took three years and tortured negotiations that lasted until the final day of the Legislative session.
But early on Thursday lawmakers gave a final nod to SB57, a bill that would require some state-regulated insurers to cover autism treatment. Pending the governor’s signature Utah will join 34 other states with autism mandates.
The bill will bring relief to many families struggling to afford expensive Applied Behavioral Analysis (ABA) therapy for their kids — but not all families, and not immediately.
Only large employer and individual health plans sold or renewed starting Jan. 1, 2016, are subject to the mandate.
These plans would have to cover 600 hours of therapy annually for children between the ages of 2 and 9, with families picking up co-payments and deductibles.
Small businesses and self-insured companies are exempt –– the exception being the state of Utah, including schools and colleges.
But HB88 will pick up some of the slack, making Utah’s autism "lottery" permanent. Lawmakers approved the $2 million measure, which will provide ABA therapy to about 270 autistic children through a lottery run by Utah’s Medicaid program.
Utah Gov. Gary Herbert called debate over the mandate philosophically interesting.
"I think we’re always reluctant about mandating anything to the private sector. This is one, because of our higher incidence of autism, that made more sense than others," he said. "For some this was a penny spent now is a dollar saved. And with autism, we’re learning the earlier intervention we can have, the better chances of being able to mainstream our young people and overcome the challenge of autism in all its different forms."
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