Under the Dome

Expanded insurance coverage for autism proposed in NC Senate

Doctors’ groups, advocates for people with autism and the state’s biggest insurer have worked out an agreement on insurance coverage in an attempt to end a long stand-off.

Senate Bill 676, sponsored by Sen. Tom Apodaca, a Hendersonville Republican, would provide insurance coverage of autism spectrum disorders.

House bills from previous sessions that would have expanded autism coverage have died in the Senate, so Apocada’s sponsorship is notable, said David Laxton, Autism Society of North Carolina spokesman.

So is BlueCross BlueShield of North Carolina’s support for the bill. The insurer has fought previous bills that focused on coverage for an intensive one-on-one therapy called adaptive behavioral analysis, saying it was educational and not medical. The N.C. Chamber had asked the legislature to move cautiously on an insurance mandate that would increase costs.

BlueCross, the Autism Society, three associations representing medical professionals, and the UNC TEACCH autism program sent out a joint statement saying they had worked together on the proposal.

The bill does not focus on adaptive behavioral analysis, but “adds flexibility by supporting a range of therapies,” supporters wrote.

The coverage would be similar to benefits the state employee health plan started offering in January, Laxton said. Benefits would be provided through age 18 and capped at $40,000 a year.

Autism Speaks, an advocacy group, pushed hard for adaptive behavioral analysis coverage, and engaged in a public battle with BlueCross over the issue that included full-page newspaper ads.

Autism Speaks was absent from the news release touting the bill. The group’s executive director for the Carolinas declined to talk about it, and lobbyists for the organization could not be reached.