Connor's law Strongly Endorsed by House Committee
By: Kristen Murphy, The New Hampshire Challenge Staff Reporter

New Hampshire families facing a diagnosis of autism spectrum disorder may receive some needed financial relief as early as next year, according to the NH Coalition for Autism Legislation. By a vote of 13 to 3, the House Committee on Commerce and Consumer Affairs endorsed House Bill 569, which amends NH's mental health parity law (RSA 415-E) at a Nov. 13 executive session.

Advocates present embraced tearfully as the final vote was called. Committee Republicans cast six of the favorable votes. "It's a clear signal to the House that both parties want to see kids with autism getting what they need to do well long term," said Debra McClure, a Temple, NH resident who has a grandson on the autism spectrum.

Also known as Connor's Law, the bill names behavioral therapy, often called "ABA" for Applied Behavior Analysis, as a covered service. None of the carriers operating in the Granite State now cover ABA.

"Current coverage excludes exactly the types of treatment that were the reason autism spectrum disorders were included in the mental health parity statute in the first place," explained Rep. Susi Nord, the Candia Democrat who headed the subcommittee responsible for researching the bill during its long sojourn through the legislative process.

"It seemed apparent to the subcommittee these treatments are widely accepted as the current standard of care and equally as effective and measurable as the treatments that are covered by insurance," said Nord.

Additionally, Connor's Law forbids health insurance companies from denying coverage "on the basis that services are habilitative in nature." Habilitation, which Nord called "an excuse" as she presented her subcommittee finding, refers to therapy that maintains a function but does not restore a capacity previously available to the patient, as is the case in "rehabilitation."

"By that logic," explained lead sponsor Rep. Suzanne Butcher, the Keene Democrat who introduced H.B. 569 at the beginning of the 2008 legislative session, "health insurance wouldn't pay for cleft palate surgery or fixing a congenital heart defect. We could barely treat infants at all."

"Habilitation" is the single most commonly cited reason for denying coverage for speech, occupational, and physical therapy for children with developmental disabilities, according to a survey sponsored by NH developmental services agencies.

Unfortunately, H.B. 569 comes too late for the family of the Seacoast area child whose name is attached to the bill. Connor was diagnosed with autism when he was just two months shy of his third birthday. At the recommendation of doctors, his parents put a vigorous treatment program in place at once.

"I know how important early intervention is, so I didn't want to waste a day," said Michelle Jarvis, who is Connor's mother and the President of the NH Autism Society.

For roughly three years, Connor received a home-based ABA program for up to 30 hours per week, along with occupational therapy, speech therapy, and ample opportunity to interact socially with his typically developing peers in local early education and school settings.

The boy's gains were remarkable. "If it wasn't working," said Jarvis, "I wouldn't have continued to pursue it. Instead I would have put my energy into finding something that did work. But we saw results right away. Connor started learning new skills immediately, and there was no question about doing whatever was necessary to continue this treatment."

Connor's mother reports that the family spent over $100,000 out-of-pocket during the 17 month period when her son's therapy was almost entirely paid for privately. "We would do it all again," said Jarvis, "no question. But the bottom line is, nobody should have to do this, and frankly, most families simply can't."

A treatment program similar to the one Connor received would be needed by approximately 315 children in the Granite State, according to a study commissioned by the NH Department of Insurance. This would translate into a total annual increase in premiums of $2 to $4 million, the report found. When measured by individual policy holder, the cost is $10 to $17 annually, an impact that Insurance Department official Leslie Ludtke termed "exiguous."

Rep. Rip Holden, a Republican from Goffstown who also served on the subcommittee charged with researching the bill, called Connor's Law a "win-win."

Holden pointed to a study prepared by the Autism Society of America at the request of NH parent advocates. ĦĦUsing the state's own actuarial impact data, the author found that over time Connor's Law would save nearly $600 million. "If these kids become productive citizens," Holden told his colleagues at a tense moment in the debate, "we've not only helped them, but we've helped ourselves as a society. Not to sound crass, but they become taxpayers."

In related news, the Senate Patient Protection and Affordable Care Act, which was released Nov. 18, became the third healthcare reform bill before Congress to include ¨C buried deep in it's more than 2000 pages ¨C a provision requiring coverage similar to that outlined by Connor's Law and required in 15 other states that have recently passed similar bills.

Insurance coverage in the Granite State is divided roughly in thirds, with one third of policies regulated by state laws such as H.B. 569 and another third regulated by federal law. The remaining third represents government programs, including NH Healthy Kids, which typically adjust coverage based on what the private market has set for an industry standard.

"When you look at the national trend, it becomes clear that this is a matter of when, not if," explained Jarvis.

The revised text of H.B. 569, which is not available through the NH General Court website, can be seen at www.connorslaw.info.