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Michigan Autism Legislation

Revised autism bill in Senate would create fund to reimburse insurers for coverage claims

By Jay Greene

Senate Majority Leader Randy Richardville, R-Monroe, has introduced legislation that would set up a new state fund to reimburse insurers and third-party administrators for the cost of claims they pay to diagnose and treat autism.

But SB 981 is “tie-barred” with SBs 414 and 415, meaning the bill would not go into effect unless all bills are approved and signed by Gov. Rick Snyder. He supports the autism legislation.

The bill has been referred to the Senate committee on health policy, chaired by Jim Marleau, R-Orion Township, who also supports autism legislation.

For more than three years, autism legislation has been stymied because the bills have required insurers to cover autism, a position that many Republican legislators and the Michigan Chamber of Commerce oppose.

Businessmen such as Dave Meador, CFO of DTE Energy, and Lt. Gov. Brian Calley support the autism coverage mandate. Both men have daughters who have been diagnosed with autism and are undergoing uninsured treatment.

About 15,000 children in Michigan have autism spectrum disorder, and 1,000 are born each year. Lifetime costs for each child average $3.7 million — or $58 billion for all children in Michigan.

Meador argues that covering autism will save Michigan millions of dollars in future health care and educational costs. Since 2001, 27 other states have approved similar bills.

National data show that one of every 110 children will be diagnosed with autism. Since 2001, children with autism in Michigan public schools have increased to more than 15,000 from 5,680.

But Mark Reinstein, president of the Mental Health Association in Michigan, said autism legislation should include language that requires insurers to offer comparable mental health coverage benefits.

“We will lobby to have mental illness, substance abuse and other developmental disabilities included or considered at the same time,” Reinstein said in a statement to Crain’s.

He did not say whether mental health advocates would oppose the autism bill if mental health parity language is not included.

“If we lived in a state that didn’t require coverage for cancer, would it be OK to pass legislation covering only one type of cancer?” Leigh Ann White, past president of the Michigan Psychiatric Society, said in a statement. “It’s past time for the Legislature and citizens to demand equal treatment for physical and mental illness.”

Federal law requires mental health parity with medical coverage for some insurers that cover large accounts, but Reinstein said the new law still leaves about 2 million Michigan residents with private insurance who are not fully covered for mental illness.

Under SB 981, the Michigan Department of Treasury has 120 days to create “an autism coverage incentive program” that would allow funds to be deposited into it from various sources. But the bill does not mandate how much funding the state Legislature should put into the autism claims fund.

“The department shall not make a commitment or exercise its authority under this act until the Legislature has appropriated sufficient funds to cover the same,” the bill says.

The department also must develop and implement an application form that can be used by carriers and third-party administrators that seek reimbursement for the coverage of autism spectrum disorders.