11 Things to Know About the Autism Insurance Bill and the NC Legislature


The Autism Society of North Carolina has been working for the past 5 years with other groups in NC to pass a law that would require private insurance and the state health plan to cover diagnosis and treatment of Autism Spectrum Disorder. We’ve written about the struggle to get a law passed in many blogs and updates. Here are a few things to know:

The cost is very, very small.

On average, 0.31 cents per health plan member, per month. $3.72 per year to help families, children, and youth with autism. The bill has several measures to ensure that costs are kept low.

The Affordable Care Act is not a problem for this bill.

The final sections of the Affordable Care Act (also called Obamacare) will be implemented in January of 2014. The ACA does not require insurance plans to cover autism treatment such as applied behavioral analysis. H 498 is written so that it exempts insurance plans that are affected by the ACA. While that leaves some insurance plans out, it also makes sure to eliminate any problems implementing autism insurance legislation for the state of North Carolina.

Autism insurance coverage has a lot of support!

Many groups are working on this, the grassroots efforts are active, and the North Carolina House passed H 498 105-7. Although the bill has not yet been heard in the Senate, NC Senators are expressing support to their constituents. The Governor says he is looking forward to signing the bill when it gets through the legislature. ASNC continues to work on getting the bill passed in the NC Senate. Your support is helping to move the bill along.

The groups involved are using different strategies to get the bill passed.

It takes a lot of different approaches to get legislation passed. Generally you need to have a good policy (often this means practical, low cost, high return, and for a good reason), have political support (the political parties agree on it, those in power want it to happen, and people see it as in their interest and in the public interest), and have grassroots support (the public wants it). All of those things need to be working in your favor to get legislation passed. Having three times the grassroots support won’t overcome a lack of political value or a bad policy (usually).

Many autism insurance coverage supporters are on multiple mailing lists, so you may see different strategies at different times. Sometimes ASNC will send an alert only to a small group of people in a single legislator’s district; sometimes we will send out a general blast to ask for lots of calls. The strategy has to fit the goal we are trying to achieve.

Changing laws often takes a long time.

No matter how right a cause is, it will still take time to convince a legislative body to pass a law. We’ve been at this for more than 5 years. This is incredibly frustrating: no matter how right you are, or how much grassroots work there is, or how much support the issue has, sometimes it takes years to create change. We keep fighting. It’s not unusual for there to be long quiet periods when nothing seems to happen and then bursts of activity. Work is being done on the bill all the time, but there is not always news to share. Be ready to take action when asked.

Some strategies are public and some are not.

Let’s face it, not everyone likes this bill: the insurance industry in every state has opposed this bill, and they are opposing it in NC. Some business groups oppose it as well. We don’t always tell the public how we are working to get it passed – we need to keep some things to ourselves. But know that ASNC and other groups are working ALL THE TIME, even if it’s behind the scenes and we can’t talk about it.

Grassroots efforts are key!

When we ask for help, it’s not lightly. We know you are busy. When we ask for help it means we really need it, enough to ask you to stop what you are doing and take a few minutes to email or call someone. Keep an eye on our talking points and always be respectful. We need to cultivate friends in the legislature. What your mom said about honey attracting more flies than vinegar? It’s true. ASNC is here to answer questions and help you make contact with your legislator. There are no stupid questions!

The legislative process is confusing. 

Some quick legislative civics 101:

Congress works in Washington, DC, on federal laws that cover all the states. The NC General Assembly works on laws that cover only North Carolina. Congress and the General Assembly each have a House and a Senate. The two Houses and two Senates have nothing to do with one another – Senators Richard Burr and Kay Hagan work in Congress and cannot help you on this bill.

H 498 to pass autism treatment coverage is being worked on by the NC General Assembly: 120 House members and 50 Senate members, all elected from parts of North Carolina and representing you here in NC. The first two maps on this page will tell you who represents you in the NC General Assembly House and Senate. For this bill, ignore the map on the bottom.

The rules to pass a bill are complicated. Here are the basics: The General Assembly introduces bills in the long session during odd-numbered years like this year, and if they pass one chamber (either House or Senate), they remain alive during that session AND during the legislative short session the following year. You often have two years to pass a bill once it is introduced. Bills only “die” if they don’t pass at least one chamber or if a committee or a chamber votes and says “no.” Bills have to pass the House and the Senate and be signed by the Governor to become law. (Yeah, it’s more complicated than that. If you are a political geek, call me and I’ll explain the details. Or you can look here for more info and a flow chart.)

If the insurance bill does not pass this session, it remains ALIVE. 

Bills passed by one chamber (in this case the NC House) can be passed by the other chamber in the long or short session. If the NC Senate waits to pass this bill until the short session, that’s another whole year that people don’t have treatment. And the short session is only 6 weeks long. That’s why we are working as hard as possible to get it passed now. But it won’t “die” if it does not pass. And we are going to keep at it until it passes. Legislators reading this: children and youth with autism cannot wait another year. We are ready to solve any problems with the bill and move it forward this year!

The legislative session does not end on June 30th this year. 

The House and Senate have approved a “continuing resolution” that will keep government operating  and legislators in session while they iron out differences in the budget, tax reform, and other bills. The continuing resolution allows them to continue the session until July 31 (or whenever they decide they are done). Time is short, but we have a little more time for them to act on H 498.

The bill does not cover everyone.

Our health-care system is made up of many pieces. 🙂 Some health plans can be changed with state laws like H 498, and some can be changed only with federal laws (that’s where Congress comes in). As another advocate said, “You don’t get the bill you love, you get the bill you can pass.” Advocates have had to make changes to the bill to get it through the legislative process and address legislators’ concerns. Every state law, including this one, is a compromise. The best chance to make sure every health plan covered under state law eventually offers this coverage is to pass this law now. Once lawmakers and businesses see the benefits of the law outweigh the tiny cost, we can strengthen the law by adding more plans and people. We must start somewhere and we are starting here and now with H 498.


One Response

  1. Thank you for all of your hard work! Thank you for working in behalf of my son and all families with loved ones with autism. Your efforts are heroic!

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