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Alaska law attempts to bridge autism health care divide

Amanda CoyneThe New York Times

One of the more emotional bills that passed the Legislature last session -- one that elicited tears by legislators and parents in the state's Capitol building -- will become law. The bill, which will require private insurance companies to cover children with autism spectrum disorder, was sent back to the Legislature on Thursday unsigned by Gov. Sean Parnell.

The mandate, Parnell said, "will likely diminish the educational costs, medical costs, and increased lifelong productivity of many individuals, including family members, all interests beneficial to the State," Parnell wrote in a letter attached to the bill.

Although it doesn't need his signature to become law, Parnell didn't sign it because he still has concerns over the cost, his spokesperson Sharon Leighow said.

During testimony, insurance companies said premium costs for those who buy private insurance could be raised as much as 3 percent as a result of the mandate. A peer reviewed study, however, said that it would be much lower than that.

The bill was introduced three years ago by Rep. Pete Peterson, D-Anchorage, and its passage was heralded as a victory for those who suffer from autism across the state.

"Today, the families of autistic children in Alaska can celebrate a bill that will not only help children, I believe it will help save marriages and families," said Sen. Johnny Ellis, D-Anchorage, who was the bill's prime sponsor, in a press release.

"Children who receive these medical treatments have a shot at staying home and out of costly institutions where they would be destined to a life of constant and intensive care," Ellis said.

Others aren't so convinced. Although the bill requires such coverage for those who buy private insurance, the vast majority of those who have health care in Alaska -- up to 85 percent -- are insured under either government or other plans. Such plans, including ones offered to legislators, are exempt from the mandate.

It's for this reason, among others, that Denny DeWitt, director of the Alaska chapter of the Independent Federation of Independent Businesses, objects to the bill and urged Parnell to veto it. 

"Why should small businesses shoulder a burden that government itself is unwilling to take on?" he said. He said that the Legislature, and now the governor, is basically saying, "We see this is a really good idea, so we're going to spend your money not ours."

DeWitt also points to a National Federation of Independent Businesses survey that Parnell filled out when he was running for governor in 2010 where he said that he generally opposed such mandates, including an earlier version of the current autism bill.

Leighow said that the governor doesn't consider allowing passage of the bill a broken campaign promise because the bill exempts small businesses.

DeWitt said that Parnell is "splitting hairs."

The bill does exempt businesses with fewer than 20 employees. Too, businesses that have between 21-25 employees can file for an exemption with the Division of Insurance if their claims have risen more than 3 percent as a result of the bill.

However, many small businesses in Alaska won't be able to opt out. The U.S. Small Business Administration defines small businesses as those with fewer than 500 employees. According to a survey conducted in 2009 and released in 2010 by the SBA, most of the 130,853 workers employed by small businesses in 2009 were employed by firms with 20 to 499 employees.

Rep. Craig Johnson, R-Anchorage, had offered an amendment that would have required the state to also mandate such coverage for its employees. When he realized that didn't have the support it needed to pass, he withdrew it.

Still, he finds the bill a little "disingenuous."

"It's terribly unfair to place all the burden on small businesses," he said. But he didn't want to deprive 15 percent of population access to such coverage, he said.

Anchorage Republican Rep. Charisse Millett, a co-sponsor of the bill, said that often times, the state mandates coverage, and then the state and the unions follow the state’s lead.

"It's a start," Millett said. "I'm not in favor of mandates but I'm also not in favor of leaving our most vulnerable citizens without coverage."

Correction: The article said that businesses that have between 21-50 employees can file for an exemption. It's been changed to between 21-25. 

Contact Amanda Coyne at Amanda@alaskadispatch.com