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Bill Summary · HB 813

Legislative bill overview

HB 813 requires health benefit plans in Texas to provide coverage for autism treatment services. The bill ensures that insurance plans cannot deny or limit coverage for evidence-based autism therapies and interventions. This applies to both state-regulated health plans and those subject to federal oversight.

Why is this important

Autism spectrum disorder affects approximately 1 in 36 children, and early intervention with therapies like applied behavior analysis (ABA) can significantly improve outcomes. Without mandated coverage, families face substantial out-of-pocket costs that may prevent access to critical treatment, creating disparities based on income level. This bill addresses a gap where some insurance plans previously excluded or severely limited autism treatment coverage.

Potential points of contention

  • Cost and premium increases: Insurers may argue that mandated coverage increases insurance premiums for all policyholders, potentially making coverage less affordable overall
  • Definition of "treatment": Debate over which therapies qualify as evidence-based and medically necessary (e.g., ABA vs. alternative approaches) and who determines this
  • Age limits and duration: Questions about whether coverage extends to adults, how long treatment is covered, and whether there are visit or dollar limits on benefits

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

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