DES MOINES, IA -- The Iowa Senate approved SF.2128 by a 43-7 vote and sent the bill to the House for further action. The bill would expand the state's 2010 autism insurance law to cover more Iowa families.
Statehouse Rally Held for New Senate Bill Expanding Coverage Under 2010 Autism Insurance Reform Law
DES MOINES, IA -- The Autism Society of Iowa Chapter hosted its 2nd Annual "Day on the Hill" February 13 at the State Capitol to help rally support for SF.2128, a newly introduced bill that would enable more families to be covered under the state's autism insurance reform law. The current law, enacted in 2010, covers only state employees.
Autism Speaks Endorses 2012 Iowa Bill Expanding Autism Insurance Coverage to More Families
Senate Bill Would Expand 2010 Law Limiting Coverage to State Employees
NEW YORK, NY (February 10, 2012)-- Autism Speaks, the world’s largest autism science and advocacy organization, today endorsed SF.2128 which would amend Iowa’s 2010 autism insurance reform law by expanding coverage to group plans for individuals with autism up to the age of 26. The current law restricts coverage to state employees.
Iowa families paying thousands of dollars a year in insurance premiums would be able to gain coverage for the screening, diagnosis, and treatment of autism spectrum disorder (ASD), including up to $36,000 a year for applied behavior analysis (ABA).
Sponsored in the Iowa Senate by Sen. Daryl Beall (D-Webster), the bill has attracted 20 Senate cosponsors and is before the Senate Commerce Committee. The measure would set no cap on visits for services and include coverage for psychological, psychiatric, pharmaceutical and therapeutic services.
“We applaud and thank Senator Beall for his leadership on this issue of critical concern to thousands of Iowa families,” said Lorri Unumb, Esq., Autism Speaks vice president for state government affairs. “Autism Speaks joins Iowa’s autism community in calling on the legislature to pass this bill and move the ball forward on autism insurance reform.”
Many states do not require private insurance companies to cover even essential autism treatments and services. In the absence of coverage, families often pay as much as they can out-of-pocket for services that can cost upwards of $50,000 per year. In the process, many risk their homes and the educations of their unaffected children – essentially mortgaging their entire futures.
A majority of states (29) representing 70 percent of the United States population have enacted autism insurance reform legislation. A number of states, such as Iowa, Vermont, Rhode Island and West Virginia, are considering bills to strengthen their existing laws and Virginia has already enacted a measure strengthening its 2011 law.
Summary of 2012 Iowa Autism Insurance Reform Bill:
SF.2128 - Sponsored by Senator Daryl Beall (D-Webster)
The bill would:
Require state-regulated health insurance group policies to provide coverage of the screening, diagnosis and treatment of autism spectrum disorders up to age 26
Direct that coverage of treatments include evidence-based care and related equipment prescribed by a licensed physician or licensed psychologist who determines that the treatment is medically necessary, including but not limited to:
Behavioral health treatment, including applied behavioral analysis (ABA) up to $36,000 per year
Pharmacy care
Psychiatric care
Psychological care
Therapeutic care
Not affect any obligation to provide services to an individual under an individualized family service plan, an individualized education program (IEP), or an individualized services plan
Apply only to state-regulated insurance plans; they do not apply to self-funded insurance plans which are regulated by the federal government under ERISA law
Apply to health plans issued or renewed in Iowa starting January 1, 2013
Help Iowa Expand the Autism Insurance Reform Law!
Autism insurance reform legislation is moving forward in the Iowa Senate!
As you probably already know, autism insurance legislation was passed in 2010 that required the state employee health plan to cover autism treatment. This was a critical step forward, but there is still work to do. The families of Iowa who are dealing with the challenges of autism need health insurance to cover treatment for their loved ones with ASD.
Watch New Law: Iowa Expands Coverage for Children with Autism NBC (WHO TV), January 2, 2011
Requires the state employees health plan to provide coverage for the diagnosis and treatment of autism spectrum disorders for state employees and their families
Coverage will be provided to individuals under the age of 21
Coverage under this law is subject to an inflation-adjusted maximum benefit of $36,000 annually
Coverage of treatments will be provided when prescribed, provided, or ordered for an individual diagnosed with autism by a licensed physician, a licensed psychologist, a licensed social worker, or a licensed registered nurse practitioner who determines the care to be medically necessary
The law includes coverage of the following treatments: Diagnosis, Habilitative or rehabilitative care, Pharmacy care, Psychiatric care, Psychological care, Therapeutic care, Applied Behavior Analysis (ABA)
The law calls for the commissioner, in consultation with the board of medicine, to adopt rules providing for the certification of behavior specialists
The law applies only to state employee health care plans
The law went into effect on January 1, 2011
Bill History:
March 14, 2012: Senate approves SF.2128 by 43-7; bill moves to the House
February 21, 2012: SF.2128 voted unanimously out of Senate Commerce Committee; Senate floor vote next
February 6, 2012: SF.2128 introduced in Senate to expand coverage; referred to Senate Commerce Committee
January 1, 2011: Autism insurance reform law goes into effect!
April 29, 2010: Governor Chet Culver enacts Standing Appropriations Bill, HF 2531, containing an amendment creating autism insurance coverage for state employees!
March 30, 2010: House passes Standing Appropriations Bill, HF 2531, containing an amendment creating autism insurance coverage for state employees. The bill heads to the Governor.
March 4, 2010: House Commerce Committee passes SF 2349 in vote of 16 to 6. The bill now heads to the full House for a vote.
February 23, 2010: SF 2349 passed by full Senate in a vote of 42-8! The bill moves on to the House for review.
February 15, 2010: SF 2349 passed by full Senate Commerce Committee. The bill heads to the Senate floor.
February 10, 2010: SF 1 is amended and passed by Senate Commerce Subcommittee. The bill number was changed to SF 2349.
May 1, 2009: 2009 legislative session ends without passage of HF 1 /SF 1.
January 12, 2009: Autism insurance reform bill, House File 1, introduced in the Iowa House by Representative Ray S. Zirkelbach. The bill is referred to the House Human Resources Committee.
January 12, 2009: Autism Insurance reform bill, Senate File 1, introduced in the Iowa Senate by Senator Daryl Beall. The bill is referred to the Senate Commerce Committee.
