By Dave Ranney
KHI News Service

A Johnson County legislator has introduced a bill that would require health insurers to cover the diagnosis and treatment of many Kansas children that have autism disorders.

“In my opinion, this is the socially responsible and moral thing to do for kids with autism and for their families,” said Rep. John Rubin, a Shawnee Republican.

Similar bills pushed by Rubin and others in 2012 and 2013, failed to advance after insurance company lobbyists characterized the initiative as a mandate that would increase health care costs and cause insurers to raise premiums.

But Rubin said he thought most of the industry’s objections to the proposal were close to being resolved.

“I’ve met with representatives of all the major health insurers in Kansas: Aetna, Conventry, Blue Cross Blue Shield of Kansas, Blue Cross Blue Shield of Kansas City, and United HealthCare,” he said. “I think there’s a general recognition that this needs to get done this year.”House Bill 2531 has been referred to the House Insurance Committee for a hearing, though that has yet to be scheduled.

The bill would require state-regulated group- and individual-market health plans in place before enactment of the Affordable Care Act to cover the diagnosis and treatment of autism for beneficiaries who are less than 19 years old.

“It will only apply to the policies that were grandfathered in after the Affordable Care Act,” Rubin said. “That’s because there are provisions in the act that say that if a state adds something to its essential health benefit package, it has to pick up the tab for whatever additional costs there might be.”

That “tab,” he said, would be “a huge fiscal note” that would kill the bill’s chances for passage.

“We’d like to have gotten this bill passed soon enough for (autism coverage) to make it into (Kansas’) essential benefit package. But that didn’t happen,” he said. “They did in Missouri, though. Wealthy people can afford this treatment and get it for their kids, and study after study show their kids do much better. But poorer and middle-class folks just cannot afford the therapies on their own.”

Rubin said if the bill becomes law it would affect about 750 of the 8,400 children in Kansas who are thought to be autistic.

“This is not my desired outcome,” he said. “I’d like it to be more, but this is what we have to deal with.”

The expanded coverage would begin Jan. 2015.

In 2010, lawmakers agreed to add autism coverage to the state employees’ health plans, partly to find out how it might affect premiums if applied more broadly.

“The average cost comes to about 17 cents per month per policy holder,” Rubin said. “That’s based on what the experience has been in Kansas and in Missouri.”

Mary Beth Chambers, a spokesperson for Blue Cross Blue Shield of Kansas, the largest health insurer in Kansas, said the company still has reservations about the bill.

“Blue Cross and Blue Shield of Kansas typically opposes mandated coverage because such mandated benefits tend to raise premiums for all people with insurance, whether they access the new benefits or not,” Chambers wrote in an email to KHI News Service. “We have been and will continue to work with the autism community to find a solution that does not raise premiums for all of our members or impose new taxes on all Kansans.”

Rubin, a retired Social Security administrative law judge, said he was weary of the insurance lobby’s argument against requiring the coverage.

“In case you haven’t noticed, just about everything we do up here – every bill we pass – involves a mandate of one kind or another,” he said. “So the question isn’t whether this is a mandate, the question is whether it’s good public policy, and whether it’s good for the people of Kansas. This certainly will help autistic children and their families.”

Michael Wasmer, associate director of state government affairs for Autism Speaks, an advocacy group, said 32 states have passed bills similar to HB 2531.