Autism Insurance Reform Gets Another Chance

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This week, the NC House passed S493, Health and Safety Regulatory Reform. The House had been debating various regulatory reform bills for the past week, and on Tuesday, they introduced a new version of S493 that included autism insurance reform with very similar bill language to House bill 498, which was passed last year, as well as other health and safety issues.  A new section requires behavioral analysts to be licensed in North Carolina by a new licensing board, which is similar to other health-care professions. Because the state employees’ health plan has voluntarily adopted autism insurance, the section of the original section that covered state employees has been removed in the new bill.

What’s next for autism insurance reform and the regulatory reform bill?

The House stripped a Senate bill that the Senate has already passed and inserted the new health and safety regulatory bill language. Because the Senate has already passed S493, they have several options for how to proceed with the new bill language. They can:

  1. Concur with the House’s version, in which case the bill has passed and can move on to the governor’s desk
  2. Or, they can vote to not concur with the new bill language, and the bill would move to a conference committee. The House and Senate would each need to appoint committee members to work out differences between the two bills before the session ends.

At this time, we do not know what action the Senate will take on the new legislation.

How you can help:

If you have not contacted your NC General Assembly senator recently about autism insurance, now is the time. You can find out who your state senator is here by entering your address in the second map.  We urge you to be respectful in your comments and ask for their support in getting autism insurance coverage passed. (Please note, we appreciate the support of our friends and family in other states, but right now legislators need to hear from people in their own districts.)

Some ideas about what to say in your message:

  1. Tell them a short version of your story of how autism is affecting you, your family, or a person you care for and what insurance coverage would mean for you.
  2. Ask them to support autism insurance reform legislation in the Senate.
  3. Treatments for the symptoms of Autism Spectrum Disorder are effective and result in better quality of life as well as lower future costs.
  4. The cost of autism health benefit coverage is very low; in states that have enacted it, the average cost is .31 cents per member per month.
  5. The bill has no Affordable Care Act impact: There is a carve-out of all ACA plans, which means the ACA is a non-issue, and guidance from the federal government is not necessary.
  6. The bill contains a small-business opt-out, if coverage related to autism causes premium increases of 1% or more.

Background: Autism insurance reform legislation was passed by the NC House last year (H498) but the bill has yet to be taken up by the NC Senate. The bill would ensure that health insurance sold in North Carolina that is regulated by the NC Department of Insurance covers the diagnosis and treatment of Autism Spectrum Disorder. The bill would cover children and young adults from birth through age 23, if they were diagnosed by the age of 8. It would cover screening, diagnosis, and a variety of medically ordered therapeutic and behavioral interventions shown to ameliorate the symptoms of autism, including applied behavioral analysis (ABA). Coverage of behavioral interventions would be capped at $36,000 per year.

If you have questions about public policy issues, please contact Jennifer Mahan, Director of Advocacy and Public Policy, at 919-865-5068 or


One Response

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