As the end of this legislative session nears, Senate President Pro Tempore Darrell Steinberg (D-Sacramento) is trying to advance a bill (SB 946) that would require private health insurers to cover an autism treatment, the Sacramento Bee reports.
Details of Bill
The bill would require private health plans to cover a therapy, known as behavioral health treatment or applied behavioral analysis, for children with autism.
Under the legislation, public health plans -- such as Medi-Cal, California's Medicaid program, and Healthy Families, California's Children's Health Insurance Program -- would be exempt from the requirement to cover the behavioral therapy. Therefore, the bill would not add costs to the state's general fund.
If lawmakers approve the bill, the coverage mandate would take effect July 1, 2012, and last two years. However, Steinberg has said that he would work to extend the requirement.
Status of Bill
SB 946 is Steinberg's third attempt to require health plans to cover behavioral therapy for children with autism. Previous versions of the legislation stalled in committee.
On Tuesday, Steinberg used the "gut-and-amend" process to delete most of what had been in the bill and add in language from his autism legislation.
On Wednesday, the Assembly Health Committee approved the new bill.
Debate Over Bill
Steinberg said that passing the legislation would be "a huge victory for families and for children."
He added that by passing the bill, California lawmakers could influence federal policy on what health services insurers must cover beginning in 2014. He said, "If California defines the essential benefits, that's going to guide the federal government's determination."
However, health insurers argue the therapy is an educational strategy, not a health need. Health plans have pointed to the fact that there is no licensing requirement for therapists who offer the treatment as proof that the therapy is about education, not medicine.
Charles Bacchi -- executive vice president of the California Association of Health Plans -- added that shifting the cost burden of covering the behavioral therapy to private health plans is unfair.
Private insurance companies say that requiring health plans to cover the autism therapy would increase policyholders' rates by at least $200 million (Rosenhall, Sacramento Bee, 9/8).