Committee chair stalls measure requiring coverage

A bill that would require Alabama insurers to provide coverage for autism therapy got one more stamp of approval in the state legislature Wednesday when the Senate Finance and Taxation committee approved it on a 14-2 vote.

But the chairman of that committee, Sen. Trip Pittman, R-Montrose, refused to transfer the bill out of committee, which means it can’t go before the full Senate for a vote. The measure gained the unanimous approval of the House earlier in the current legislative session, which must end by May 20.

Earlier this week, Blue Cross Blue Shield of Alabama, the state’s largest insurer, offered to cover autism therapies in exchange for an age cap. Pittman attempted to add amendments that would exempt the state’s public insurers, like teachers and state workers’ insurance, as well as Medicaid, from the mandate. Pittman said the reason he would not allow the bill out of committee was because as currently proposed, it would “blow our budget wide open.”

It’s a bill being watched closely by families across the state who have been affected by autism. The therapy has already helped 6 year-old Judd Copeland, and his family says greater access to applied behavioral therapy could help him even more.

“Right now, Alabama is still just 1-of-4 states where insurance doesn’t cover autism,” Judd’s mother, Shelley Wages, said. “The therapy is very expensive and a lot of families aren’t able to afford it out of pocket.”

Wages said that just before turning 3, Judd was diagnosed with autism.

“He could sit there and label every one of his Thomas trains, but he wasn’t able to tell us what he wanted,” Wages said. “He could copy what you said to him, but he just wasn’t able to communicate to us what he needed and he would get very frustrated.”

That’s when they got Judd into Applied Behavior Analysis therapy and things really began to change.

“ABA therapy has been amazing for him,” Wages said. “It’s easy to see how much that it has helped him, but it’s a strain financially. It has really done wonders for Judd. He use to panic in public situations and now he is able to function in a normal classroom. I really believe that’s because of the therapy that he has received. I was working two jobs to be able to get him the therapy that he needs and even then we couldn’t afford to send him as much as he needed to go.”

ABA therapy centers around each child’s specific needs and is most effective when started between the ages of two and five, but the cost can be very significant.

“The therapy is very expensive,” Wages said. “Judd’s are $110 per session and it was recommended that he go five times a week, but we just couldn’t afford to send more than once a week. We were fortunate enough to be able to afford to send him because there are a lot of families that just can’t do it, and that’s why this legislation is so important to the State of Alabama.”

With Blue Cross Blue Shield committed to providing coverage for ABA therapy, Wages said that it’s a blessing for everyone.

“This is very important for everybody,” Wages said. “There are a lot of families who are going to benefit financially from this, but most importantly, there are a lot of children are going to be able to get the therapy that they need to help them.”

“Blue Cross Blue Shield hasn’t wanted to support this, but if people would do the research they would see that the premiums aren’t going to go up by but about 25 or 50 cents,” Wages said. “We are blessed enough that we were able to get Judd some treatment, but there are families that have to mortgage their homes in order to pay for the therapy. That’s not right. If someone is diabetic, the insurance company isn’t going to tell them they won’t cover insulin. This isn’t any different than that. I think if people could really see the difference that the therapy it makes and the financial strain that it can place on a family, they would be more inclined to support this bill. We hope it passes because there are a lot of families that it would take a little weight off of their shoulders.”

Several members of the legislature have threatened to shut down the Senate – which still has to finalize the state’s budgets – if the bill is not passed.

Both the Business Council of Alabama and Blue Cross and Blue Shield of Alabama have opposed the bill, comparing it to Obamacare and saying it will ultimately increase premiums.