By Chip Brownlee
Alabama Political Reporter
MONTGOMERY — An unlikely issue has become one of the most contentious topics in the State House this session: mandating insurance coverage for an autism spectrum therapy called applied behavioral analysis therapy.
The debate over a bill that would provide just that has many senators demanding a vote and some promising an inconvenient slowdown in Senate business if the opportunity for one isn’t provided. The bill’s supporters say the mandate is needed to ensure families can afford the important but expensive therapy.
“We’re going to have us a hard vote count in committee next week, or we’re going to have a rough rest of the session,” Sen. Cam Ward told APR.
Sens. Tom Whatley, Dick Brewbaker and Ward, all Republicans, are promising to hold up Senate progress if Sen. Tripp Pittman, General Fund Taxation Committee chairman, doesn’t give them a vote on Whatley’s bill that would require insurance companies in the state provide coverage for the therapy.
The senators say Pittman has promised them a vote next week in committee. Regardless, the trio says they’re still prepared to hold up the Senate if a vote in both the committee and on the floor doesn’t come.
“I feel like we’re going to get a vote in committee, but the question then becomes do we get a vote on the floor,” Ward said. “Around here, with some of the procedural games that are being played, you never know.”
Earlier in the day, proponents of the bill flocked to the committee’s foray in committee and begged lawmakers to pass the mandate so parents can afford the life-changing therapy for their kids on the spectrum. Ward, in particular, has a personal stake in the matter.
His 14-year-old daughter, Riley Ward, is on the spectrum and has had the therapy. She spoke to the committee Thursday, crediting therapy for her ability to speak in front of a room packed with legislators and onlookers.
“I grew up in my dad’s political life, going to boring dinners,” Riley Ward said. “I would lay on the floor and watch DVDs to block out the loudness. Without the help this coverage would provide, I wouldn’t be able to speak here today.”
Ward said his family helped him and his wife pay for Riley’s therapy, but for other families, it is often too cost prohibitive.
The coverage can cost thousands of dollars a month if it isn’t covered by a family’s health insurance coverage. In Alabama, the ABA therapy is currently not covered by Blue Cross Blue Shield, the state’s largest provider.
Forty-five other states have mandated the coverage. Alabama is one of the few that doesn’t. But detractors, including the Business Council of Alabama and conservative Republicans in the State House, say the bill would raise insurance premiums for the average family.
“Blue Cross has always opposed mandated benefits, and probably always will. We think that’s an employer’s decision,” said Robin Stone, a lobbyist for BCBS.
The bill was passed by the House last month by a unanimous vote but has gotten caught up in the Senate by the leadership. With only six legislative days left in the session, supporters are moving quickly to get the bill through.
Similar mandates passed in other states like Missouri have cost state insurance programs less than a dollar per member per month to provide. A mandate in Alabama would increase Medicaid costs by about $5 million in state funding, Ward said.
But it would pay off later.
“This therapy, if you get it early enough, can help people on the spectrum live a regular life like an independent individual,” Ward said. “Otherwise, they are going to be a burden on the state budget long term.”
Several legislators also raised concerns about whether the government should be mandating any type of insurance coverage, echoing the complaints raised by the BCA and BCBS. Ward said mandates are impossible to avoid.
“Sometimes we get too philosophical in this building,” Ward said. “We are totally against mandates. We have a hard-core ridge idea that you’re hard-core this or hard-core that. At the end of the day, it’s easy to write down our political philosophy, but how do you argue political philosophy with a family who can’t afford this therapy.”