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Key Votes

SB 414 - Health Care Coverage for Treatments Relating to Autism - Key Vote

Michigan Key Votes

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Legislation - Concurrence Vote Passed (Senate) (30-8) - (Key vote)

Title: Health Care Coverage for Treatments Relating to Autism

Vote Smart's Synopsis:

Vote to concur with House amendments and pass a bill that requires insurance providers to cover the diagnosis and treatment of autism.

Highlights:
  • Requires insurance providers to cover the diagnosis and treatment of autism spectrum disorders.
  • Defines “autism spectrum disorders” to include the following:
    • Autistic disorder;
    • Asperger’s disorder; or
    • A "pervasive developmental disorder not otherwise specified".
  • Prohibits insurance providers from doing any of the following:
    • Limiting the number of visits a member may use for the treatment of an autism spectrum disorder;
    • Denying or limiting coverage on the basis that treatment is educational or habilitative in nature; or
    • Subjecting coverage to dollar limits, copays, deductibles, or coinsurance provisions that do not generally apply to physical illnesses.
  • Specifies that coverage for the treatment of autism is required through 18 years of age with a maximum annual benefit of:
    • $50, 000 for a covered member under 6 years of age;
    • $40, 000 for a covered member with an age of 7-12 years; and
    • $30,000 for a covered member with an age of 13-18 years.
  • Specifies that beginning January 1, 2014, the coverage requirements outlined in this law are not necessary for a qualified health plan that exceeds coverage included in the “essential health benefits” required under the Federal Patient Protection and Affordable Care Act.
Legislation - Bill Passed With Amendment (House) (91-19) - (Key vote)

Title: Health Care Coverage for Treatments Relating to Autism

Vote Smart's Synopsis:

Vote to pass a bill that requires insurance providers to cover the diagnosis and treatment of autism.

Highlights:
  • Requires insurance providers to cover the diagnosis and treatment of autism spectrum disorders.
  • Defines “autism spectrum disorders” to include the following:
    • Autistic disorder;
    • Asperger’s disorder; or
    • A "pervasive developmental disorder not otherwise specified".
  • Prohibits insurance providers from doing any of the following:
    • Limiting the number of visits a member may use for the treatment of an autism spectrum disorder;
    • Denying or limiting coverage on the basis that treatment is educational or habilitative in nature; or
    • Subjecting coverage to dollar limits, copays, deductibles, or coinsurance provisions that do not generally apply to physical illnesses.
  • Specifies that coverage for the treatment of autism is required through 18 years of age with a maximum annual benefit of:
    • $50, 000 for a covered member under 6 years of age;
    • $40, 000 for a covered member with an age of 7-12 years; and
    • $30,000 for a covered member with an age of 13-18 years.
  • Specifies that beginning January 1, 2014, the coverage requirements outlined in this law are not necessary for a qualified health plan that exceeds coverage included in the “essential health benefits” required under the Federal Patient Protection and Affordable Care Act.
Legislation - Bill Passed (Senate) (29-9) -
Legislation - Introduced (Senate) -

Title: Health Care Coverage for Treatments Relating to Autism

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