Last week, so many supporters came from across the state to testify that the Senate Committee on Small Business and Insurance had to reschedule a hearing for the opposition. In the first hearing, tears were shed and pictures of children were placed on a podium facing the panel of senators.
Tuesday was more business as usual.
A slew of insurance lobbyists, whether from Anthem Blue Cross Blue Shield or Coventry Health Care, said the proposed autism mandate -- like any other -- would raise the cost of premiums. David Smith, a representative for Anthem Blue Cross Blue Shield, said their analysis showed the cost of each policyholder's premium rising anywhere from 2 to 3.5 percent per month.
Another common point was that Applied Behavior Analysis, popularly referred to as ABA, was an educational tool that could be used for autism, but not a medical necessity.
Most of the parents of autistic children who testified last week disagreed. At that hearing, several parents spoke of the strides their children had made through ABA therapy, which one parent said cost as much as $100 per hour.
The bill would provide coverage of ABA therapy at up to $72,000 per year, a price many families with autistic children are forced to cover out-of-pocket, and which most insurance companies do not cover.
"This is a needed benefit to these children and their families," Cheryl Dillard, a spokeswoman for Coventry Health Care said of ABA therapy. "The question we're raising is, how is the best way to cover that? As insurers, we can cover anything that the legislature or the market wants us to. We're willing to do that; we have the means to do that; we can do that."
Asked then by state Sen. Jason Crowell, R-Cape Girardeau, why ABA therapy is not covered, Dillard responded that Coventry was not hearing from customers that they want it to be.
The insurance companies took several cues from Crowell, who asked last week whether it was worthwhile to pass a bill that only covered 40 percent of the autistic population. Small businesses and state workers, among others, would not be covered under the bill.
"I don't want to dislocate my shoulder while patting myself on the back for doing something that seems like it helps everybody when it doesn't," he said, questioning if supporters of the bill thought they would receive coverage when many would not.
This week Shannon Cooper, a lobbyist with America's Health Insurance Plans, referred to Crowell's idea of "picking winners and losers" among the autistic community as justification for why he should oppose the bill. Cooper and Smith said the bill would only cover 12 percent of the autistic population, while another lobbyist, Brent Butler, put the figure at 20 percent.
Many of the lobbyists are practiced witnesses, regularly at the Capitol as part of their job. The bill's sponsor, Scott Rupp, R-St. Charles County, sat by as the lobbyists he has worked with on the bill testified against it.
Partway through Smith's testimony, Rupp passed him a note that said, "Don't worry, I'll still be your facebook friend."