Dear Friends,
 
As perhaps you know there has been considerable confusion about bills before the legislature during the 2009 Session that would have compelled some private insurers in Virginia to provide autism coverage.  And now, as you may have read, a candidate has criticized me (and therefore a host of both Republican and Democratic delegates) for what was in fact a conscientious response to a difficult issue.
 
Without clear information and context this potentially emotional issue cannot be understood.  Accordingly, I offer you a synopsis of the bills presented to the House and Senate during the 2009 Session.  Included is an explanation of the respective chambers' responses. 
 
There were two, identical bills in the General Assembly that would have mandated health insurance coverage for "autism spectrum disorder."  This is a complex disorder, of no clear cause and of no definitive cure.  Children with autism encounter serious difficulties in communication, social inter-action, etc.
 
In the House of Delegates, House Bill (HB) 1588, and in the Senate, SB 1260, would have required "health insurers, health care subscription plans, and health maintenance organizations to provide coverage for the diagnosis and treatment of autism spectrum disorder in individuals under age 21."  Each bill included a cap of $36,000 in benefits annually.
 
The Senate bill was reported from the Commerce and Labor subcommittee on a vote of 11-5.  Those voting against the proposal included our Senator John Watkins.  Subsequently, after further testimony on the matter, the bill was referred to the Senate Finance committee and there it was left, without further action.
 
In the House, HB 1588 was heard in the subcommittee that I chair for the Commerce & Labor committee.  In addition to testimony for the bill from its patron and several parents, we heard testimony against HB 1588 from a score of employers, employees, and insurance groups, including the Virginia Chamber of Commerce and the Greater Richmond Chamber of Commerce. 
 
Keith Cheatham, vice president of the Virginia Chamber, pointed out one of the principal weaknesses of HB 1588 (and also SB 1260) when he asked, "Do we want more expensive health insurance coverage for fewer people, or do we want more affordable health insurance coverage for most people?" 
 
A Limited, Costly Proposal

Both autism-insurance bills of 2009 would have affected only about a 25% of insurance plans.  Large, self-insured employers, such as the major corporations of the Richmond area and even state employees of the Commonwealth, would not have been covered.  So the cost of the mandate would have fallen on smaller employers, and no one, on either side of the aisle, was prepared to add mandated costs to small employers during an economic recession.
 
When HB 1588 was heard in my subcommittee, six members were present--three Republicans and three Democrats.  When I called for a motion, no motion was offered.  Not a Republican, not a Democrat, believed that HB 1588 was the proper vehicle for helping families with autistic children in Virginia.  The protocol in such a situation, when no motion is offered, is for the chair to rule the matter moot, and this I did.
 
Later, the patron of HB 1588 asked the full House to reconsider the bill.  That motion was rejected, 63-32-1, and the nay votes were cast by a broad bipartisan consensus.  A Democrat whom I greatly admire, Delegate Algie Howell of Norfolk, was among the Democrats who voted against reconsideration.  Consequently, he, too, is being criticized in this campaign (by a Republican challenger) for doing what was in fact in the best interests of the vast majority of Virginians.  Also voting against the motion to reconsider were my neighboring Delegates Manoli Loupassi, Sam Nixon, Kirk Cox, John O'Bannon--a medical doctor--and Riley Ingram.  In other words, the entire Chesterfield delegation rightly opposed a well-intentioned but too-widely drawn bill that would have placed an undue burden on the small businesses--and thousands of families--of Virginia.
 
One other feature of HB 1588 must be noted.  HB 1588 would have required affected insurers to provide coverage "for the diagnosis and treatment of autism spectrum disorder in individuals under the age of 21."  By comparison, when the legislature of Texas in 2007 passed a mandate for autism insurance, coverage became required "for children between the ages of three and five."  That is a drastically different mandate than the one proposed by HB 1588.  More recently, the South Carolina legislature mandated coverage for children "diagnosed at age eight or younger."  Benefits would be provided only to children under age 16.
 
More recently, the U.S. Senate, last week, included an autism-coverage element in the proposed federal health insurance bill being considered in both chambers of Congress.
 

2010 Expectations
 
Since the 2009 Session I have talked with several fellow legislators about how to craft a bill that would spread the costs and also include employees of large corporations and also state employees.  Just this week I met with a leading member of the Virginia Autism Project.  I reiterated my willingness to support an insurance bill that makes sense for all Virginians.  And, I plan to co-patron an important companion measure for autistic children.  This is a bill that would create a basic training program for the appropriate aides in our public schools.  At present, aides often do not know enough about autism as a disorder or about the special needs of autistic children.  What we need is a basic training program, taught by experts in autism education, so that autistic children can take full advantage of our public schools.
 
Passions ran high during debate on the autism bills in the House and Senate last winter.  My responsibility as a subcommittee chair is to ensure that passions do not trump civility and reasoned judgment.  The vast majority of members of both the House and also the Senate shared that view, and voted--or offered no motion that would have ensued in a vote--in good faith and in good conscience.
 
My opponent this year says that he would have voted for HB 1588.  Evidently his claim and certain of his caricatures sway some.  I am content to believe that it is easy to promise anything to garner votes on a subject that tears at the hearts of all of us.  I also believe that the responsible approach was the one taken by the large majority of Republicans and Democrats alike during the 2009 Session.  And I further believe that a much-improved bill will come before us in 2010 precisely because of the debates and careful deliberations that we devoted to autism insurance during 2009.
 
Cordially,
 
Lee Ware