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HF 5

A bill for an act relating to insurance coverage for covered individuals for the treatment of autism spectrum disorder and including applicability provisions.

2025-2026 Regular Session Introduced by Eddie Andrews

Bill HF 5 aimed to expand autism treatment coverage by removing age limits and benefit caps, ensuring individuals of all ages access necessary therapies without financial constraints.

Withdrawn.
#autism #healthinsurance #medicalcare
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Bill Summary · HF 5

Summary of Bill HF 5: Insurance Coverage for Autism Spectrum Disorder

Bill Overview

Bill Number: HF 5
Title: A bill for an act relating to insurance coverage for covered individuals for the treatment of autism spectrum disorder and including applicability provisions.
Status: Withdrawn
Introduced: January 14, 2025
Classification: Bill
Subject: Autism, Health Insurance, Medical Care

Purpose and Intent

The primary aim of Bill HF 5 was to enhance insurance coverage for individuals diagnosed with autism spectrum disorder (ASD). The bill sought to remove existing limitations on age and maximum benefit amounts for treatment, thereby expanding access to necessary medical care for individuals with autism.

Key Provisions

  1. Removal of Age Limitations:

    • The bill proposed to eliminate the current age cap of 21 years for coverage of autism treatment. This change would allow individuals of any age to receive necessary diagnostic assessments and treatment.

  2. Elimination of Maximum Benefit Amount:

    • The existing law stipulated a maximum benefit of $36,000 per year for autism treatment. HF 5 aimed to remove this cap, allowing for potentially unlimited coverage based on medical necessity.

  3. Coverage for Applied Behavior Analysis (ABA):

    • Under current law, coverage for ABA therapy was limited to individuals under 19 years of age. The bill sought to extend this coverage to individuals of all ages, ensuring that they could receive this critical form of therapy as part of their treatment plan.

  4. Applicability:

    • The provisions of the bill would apply to third-party provider payment contracts, policies, or plans specified in section 514C.31, and to plans established for public employees (excluding state employees) that are delivered, issued for delivery, continued, or renewed in the state on or after January 1, 2026.

Impact

  • Who Would Be Affected:

    • The bill would have impacted individuals diagnosed with autism spectrum disorder, their families, and healthcare providers offering treatment services. It aimed to provide broader access to necessary treatments and therapies without the constraints of age or financial limits.

  • Healthcare Providers:

    • Providers of autism treatment services, particularly those offering ABA therapy, would benefit from the expanded coverage, potentially leading to increased demand for their services.

Legislative Timeline

  • January 14, 2025: Bill introduced and referred to the Commerce Committee.
  • January 27, 2025: Subcommittee meeting held; recommended passage.
  • February 6, 2025: Committee reported the bill with recommendations for amendment and passage; committee vote was unanimous (23-0).
  • February 11, 2025: Bill was approved by the committee and renumbered as HF 330.
  • February 24, 2025: Bill was withdrawn.

Conclusion

While HF 5 aimed to significantly improve insurance coverage for autism treatment, it was ultimately withdrawn before further legislative action could be taken. The proposed changes would have had a substantial impact on the accessibility and affordability of autism care for individuals and families affected by ASD.

Compiled from official sources — confirm details with the bill’s official record.

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