California Gov. Jerry Brown signed Senate Bill 946, which has also been dubbed the "Autism Bill," on Sunday. The legislation seeks to guarantee insurance coverage of "behavioral health treatments" for those suffering from disorders falling into the autism spectrum. Although a positive step, this victory is only temporary. What does SB 946 accomplish -- and for how long?
Is it true the benefits of SB 946 are only temporary?
Yes, it is. As outlined in the governor's signing message, the "new law is effective as of July 1, 2012, and expires July 1, 2014." In fact, Around the Capitol highlights that an automatic repeal of the provisions will take place on Jan. 1, 2015.
Who benefits?
The legislation affects patients diagnosed with autism or any other type of "pervasive developmental disorder," if they are covered by health care service plan contracts or standard health insurance policies.
What does SB 946 provide to patients?
It mandates insurance coverage of behavioral health treatments if a patient has been diagnosed with autism spectrum disorders or suffers from a persistent developmental disorder.
What else does the legislation accomplish?
SB 946 institutes an Autism Task Force that must be operative by Feb. 1. Its stated goal is to render assistance to the Department of Managed Health Care insofar as behavioral health treatments are concerned. In addition, the task force is charged with drafting recommendations pertaining to training, schooling and licensure requirements. The bill carefully denotes the acceptable payment formulas to be used for the treatments. Lawmakers highlighted that in contractual negotiations between state and county -- or county and associated service provider -- only "net amounts" can be used as costs. County mental health programs cannot charge more than actual service costs. "Incentives relating to economy and efficiency" are specifically excluded from rate-setting methods.
Why did Gov. Brown seem less than enthusiastic in his signing message?
The governor applauded the idea of providing "relief for families of autistic children" and also supported health plans would receive some clarity. Even so, he questioned the bill's "effectiveness, duration and the cost of covered treatments." Another fly in the ointment is the possibility that national health care reform will fail to define behavioral treatments as essential health benefits. In this case, the patients will automatically lose the benefits offered by the autism bill. It is unclear how this will affect -- in the long run -- patients responding well to the treatments.
Who opposes SB 946?
The California Association of Health Plans has strongly opposed passage of the autism bill. A Sept. 26 news release claimed the mandates set forth in SB 946 "would increase all Californians' health care costs by nearly $850 million a year." Moreover, the organization warns children relying on CalPERS, Healthy Families and Medi-Cal coverages would not receive the same benefits as those covered by private plans.
Sylvia Cochran is a Los Angeles area resident with a firm finger on the pulse of California politics. Talk radio junkie, community volunteer and politically independent, she scrutinizes the good and the bad from both sides of the political aisle.
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