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House Leaders Head For Clash With Senate's Autism Measure

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By CATHERINE DOLINSKI

The Tampa Tribune

Published: April 30, 2008

TALLAHASSEE - House Speaker Marco Rubio is "swinging for the fences" when it comes to his health insurance agenda, vowing Tuesday that he will negotiate all night, every night if needed to pass his version of legislation to cover children with certain developmental disabilities.

Both chambers are pressing proposals to expand health insurance coverage of autistic children in Florida. But the House version is more expansive and more costly, and, unlike the Senate version, has yet to pass either chamber. The House advanced its version Tuesday night for a final vote before the end of the legislative session Friday.

Rubio denied taking an all-or-nothing approach, but said that he isn't willing to settle for anything short of "meaningful and comprehensive" reform.

Steve Geller, sponsor of a leaner Senate version, complimented Rubio's passion for the issue but said his approach is likely to backfire.

"I believe that they are more likely than not killing the bill and making sure no one gets anything," said Geller, Senate minority leader from Cooper City.

Rubio told reporters: "There are some who will advocate towards getting what we can, while we can get it now, and we'll deal with the rest later. It's a strategy we've employed on other issues in the past and it hasn't worked out. ... On some issues you can tolerate that. This is not one of them."

Covering Autism

In many cases, early intervention with intense therapies can transform the lives of developmentally disabled children. But the costly therapies are often beyond the reach of many families, and not often covered by insurance.

Last week, the Senate passed Geller's bill requiring that large health insurers cover therapies for children with autism, benefiting roughly 7,000 to 8,000 children. House leaders say it's not enough.

"If we were to take the Senate proposal today, only 13 percent of the autistic children in the state of Florida would actually be covered by that particular proposal," said Rep. Andy Gardiner, architect of the plan and leader of the House's autism committee. "No other disabilities at all would be covered. ... If we're going to look at a mandate, we should look at everything."

Tuesday night, the House advanced its own bill, which would expand private and government-sponsored health insurance to cover therapies for autistic children and those with cerebral palsy, Prader-Willi syndrome, Down syndrome or spina bifida.

Effective July 1, 2009, private insurers would have to cover therapies for such children; the state KidCare program would have to provide such benefits starting Oct.1, 2009. The plan would also lift a current cap on the number of enrollees who are currently too wealthy to quality for KidCare, allowing them to buy into the program.

Initially, the bill had scheduled the KidCare portion of the plan to start Jan. 1, 2009, launching it in the middle of the coming fiscal year and raising concerns from child advocates about funding. During budget negotiations this month, the only funding source that the House identified was $13.4 million that both chambers had set aside to expand the number of subsidized slots in KidCare for low-income children. The new schedule pushes the start into the next fiscal year.

Child advocates have raised concerns about potential increases in KidCare premiums that would result from offering a developmentally disabled benefit costing up to $36,000 a year per child. According to Healthy Kids director Rich Robleto, covering a child through KidCare normally averages about $1,300 a year.

Gardiner, R-Orlando, said he pushed the start of the KidCare portion later than the start of the insurance mandate in response to concerns that families who want the costly benefit would flood the KidCare program, sending premiums soaring. Gardiner said the bill now caps those premium increases at 5 percent.

The House's plan sounds great, Geller said. "If they had only funded it."

Geller predicts that Rubio's plan would reach up to 80,000 disabled children, many of whom might enroll in Healthy Kids - yet the bill identifies no source for resulting costs.

"It's dramatically more expensive, and they haven't funded it," Geller said. "The Senate's not going to go along with that; we have an opportunity here to help thousands and thousands of children. We should do so - not say, 'We've got to get everything, or we'll settle for nothing.'"

Bill's Education Component

House leaders say the fiscal impact is uncertain because it is unknown how many families would enroll in Healthy Kids to get the new coverage, when they would enroll or what services they would need.

The House plan also contains an education component, allowing parents of developmentally disabled parents to spend their voluntary prekindergarten dollars on speech and occupational therapies and, if necessary, move directly into private schooling by way of a McKay Scholarship for developmentally disabled students.

Geller has said he has no problem with the expanded use of vouchers. Tuesday, he complimented Rubio and Gardiner on their commitment to the overall bill but warned against the perils of ambition. "We cannot let the perfect be the enemy of the good."

Reporter Catherine Dolinski can be reached at (850) 222-8382 or cdolinski@tampatrib.com.

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