MONTGOMERY — The Alabama Senate's powerful Republican leadership has promised a full chamber vote on a bill mandating insurance coverage for a type of autism therapy. The bill caused a split in the Senate Republican caucus.
Senate President Pro Tem Del Marsh, R-Anniston, said Thursday he had worked out an agreement with the bill's supporters and budget committee chairman Sen. Trip Pittman, R-Montrose, to allow the bill to the floor. Pittman had threatened to hold the bill in committee Wednesday, even after it passed with only two nays.
Marsh said the bill will get a full day's focus Wednesday. It will be the only bill on the day's special order calendar.
"It is our full intention to take full attention to that bill on Wednesday," Marsh said. "That gives us Wednesday,
The bill, which would mandate insurance coverage for an autism spectrum therapy called applied behavioral analysis therapy, has had many senators demanding a vote and some promising an inconvenient slowdown in Senate business if the opportunity for one isn’t provided.
Auburn's Sen. Tom Whatley is the senate sponsor of the bill, which was passed by the House earlier in the legislative session. Whatley and the bill’s other supporters say the mandate is needed to ensure families can afford the important but expensive therapy.
"There is a cost to it. It is a mandate, but we mandate things every day," Whatley said. "I think one of our charges is to take care of people and take care of families. When you see a parent who sees a reaction from his or her child, that is priceless."
The coverage can cost thousands of dollars a month if it isn’t covered by a family’s health insurance coverage. The therapy costs upward of $120 an hour. In Alabama, the ABA therapy is currently not covered by Blue Cross Blue Shield, the state’s largest provider.
The bill would force BCBS and other insurance providers, including state providers, to cover the therapy. The costs of the therapy could cause premiums to rise between $1-4 a month, based on numbers from other states similar in size to Alabama that have implemented similar provisions.
Auburn is one of the only schools in the Southeast to train ABA practitioners, and many have to go out of state to find jobs, Whatley said. So for him, the bill is not only positive for families but for the University and his district as well.
"One out of 68 kids has something on the autism spectrum," Whatley said. "Auburn University provides this ABA training at the school. That's our largest employer. I've got an economic look at it as well as an emotional community issue. We have a large autism community in the Auburn area."
Alabama would not be the first to mandate the coverage; it would actually be one of the last. Forty-five other states have already mandated the coverage.
Regardless, Pittman said the decision to let the bill move out of committee was a hard one. Pittman's comments Wednesday sparked controversy. Whatley, Sen. Cam Ward and Sen. Dick Brewbaker, all Republicans, promised to filibuster and hold up Senate business if there was no floor vote. They did the same thing last week to get a committee vote.
If the group of Republican senators had lined up with Democrats who have also been supportive of the bill, they could have ground the legislative session to a halt only four days before the session is set to end.
After urging from Marsh Wednesday afternoon, Pittman changed his tune.
"This has been one of the most difficult decisions I've had to make," Pittman said Thursday. "After nine years of balancing budgets and trying to pay back debts, this is a very sensitive issue and a very important bill that affects a lot of people. At the end of the day, we have to be able to pay for the costs of it."
Last week, proponents of the bill flocked to the bill’s foray in committee and begged lawmakers to pass the mandate so parents may be able to afford the life-changing therapy for their kids on the spectrum.
Ward has been a strong advocate of the bill and has a personal stake in the matter.
His 14-year-old daughter, Riley Ward, is on the spectrum and has had the ABA therapy. Riley, speaking to the committee last week, credited the therapy for her ability to speak in public.
“I grew up in my dad’s political life, going to boring dinners,” Riley Ward said. “I would lay on the floor and watch DVDs to block out the loudness. Without the help this coverage would provide, I wouldn’t be able to speak here today.”
Brewbaker said he has confidence that Pittman and Marsh will keep their word, but maybe not for the right reasons.
"Sometimes it's good to be in an election cycle, and this is one of those times," Brewbaker said. "I've been in the Legislature almost 12 years, in either the House or the Senate, and I've never seen a chairman hold a bill that's passed a committee overwhelmingly because he was just opposed to the bill."
The bill passed committee Wednesday with several amendments. If it is passed by the Senate, it will have to go back to the House for a concurrence vote. If it's passed by both Houses, it will head to Gov. Kay Ivey's desk for her signature.
Chip Brownlee reported from the State House in Montgomery.
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Chip Brownlee, senior in journalism and political science, is the editor-in-chief of The Auburn Plainsman.
