The appointee doctors, administrators, insurance executives and legislators voted to recommend that the General Assembly not order individual and small-group plans to cover early treatment of autism, children’s hearing aids and physician-prescribed diets. The vote was the outcome of hearings in which commission members heard tearful testimony from parents, patients and medical professionals about the need for each of these treatments.
The vote, though, hinged on costs.
Rep. Richard Smith, who chairs the commission and the House Insurance Committee, said before the votes that the new coverage requirements would only apply to individual and small-group plans sold through the federally run health exchange, not to large companies’ self-insured plans that cover three out of every four insured Georgians. Plus, Georgia taxpayers would have to subsidize the cost of the increase for policyholders earning less than $95,000 for a family of four.
“That is an issue, especially when you consider the uproar that we’ve been listening concerning people whose premiums have doubled and tripled,” said Smith, R-Columbus. “They’re upset about a lot of things as far as insurance premiums.”
Insurance Commissioner Ralph Hudgens summed it up before the voting.
“Under the Affordable Care Act, the state has to pick up any new mandates that are added at this time to the qualified medical plans, and this can be very, very expensive to the state,” he said. “... All mandates cost.”
Supporters of the proposals briefly argued that requiring early autism coverage, children’s hearing aids and prescribed diets would result in savings in the long run.
“Ultimately, this is going to save $1 million per child,” said Sen. John Albers, R-Roswell, the Senate sponsor of the early autism bill.
Addressing the condition as a toddler is easier and less expensive than waiting until school age.
Rep. Ben Harbin, the House sponsor, said that the Legislature had mandated other coverage such as prostate and breast-cancer screening with the same goal of long-term savings. Plus, people’s quality of life can be impacted by the mandates.
“Sometimes, we have to step up and do the right thing,” said Harbin, R-Evans.
Smith said the commission vote did not kill the legislation, but he said if the bills are changed to address any of the objections, then the commission would review the revisions before the House or Senate ultimately decides.