Iowa House Bill HF243

Iowa 2023-2024 Regular Session

• Introduced: 2/8/23
• Engrossed: 2/15/23
• Refer: 2/16/23

Caption

A bill for an act relating to insurance coverage for covered individuals for the treatment of autism spectrum disorder.(Formerly HSB 74.)

Impact

By amending multiple regulations within Code section 514C.22, the bill seeks to enhance the availability of treatment options for individuals diagnosed with autism. Under the revised law, insurance policies will now have to offer more comprehensive and limitless coverage for autism treatments, thereby potentially lowering out-of-pocket costs for families. Moreover, this move is anticipated to lead to broader acceptance and utilization of applied behavior analysis therapies, which are critical for the development of children and adults with autism.

Summary

House File 243 addresses the insurance coverage for individuals requiring treatment for autism spectrum disorder. This legislation significantly alters the existing insurance mandates by eliminating age restrictions and maximum benefit amounts previously set under state law for autism treatment. Specifically, the bill removes the limitation of coverage only for those under 21 years of age and also abolishes the annual cap of $36,000 for treatments related to autism. This change aims to expand access to necessary care without the constraints of age or financial coverage ceilings, ensuring lifelong support for individuals affected by autism spectrum disorder.

Contention

Despite the positive impacts projected by supporters, such as improved health outcomes and financial relief for families, some concerns have been raised regarding the potential strain on insurance providers. Critics argue that the removal of coverage limits may lead to increased premiums or changes in policy structures as insurers adapt to the new mandates. Furthermore, there is an ongoing debate about ensuring that all autism-related therapies meet the necessary standards for efficacy while adequately addressing the needs of those affected. Opposition from certain insurance industry stakeholders indicates that while the expansion of coverage is necessary, the implementation must be carefully managed to sustain the insurance market's viability.