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Bill

SB 563

Relating to health benefit plan coverage for treatment of autism spectrum disorders.

89th Legislature (2025) Introduced by José Menéndez

SB 563 mandates Texas health insurance plans cover evidence-based autism spectrum disorder treatments, expanding access to behavioral and diagnostic services for affected families.

Referred to Health & Human Services
#autism&pervasivedevelopmentaldisorders(s0566) #health--otherdiseases&medicalconditions(i0383) #insurance--health&accident(i0422)
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Bill Summary · SB 563

Legislative bill overview

SB 563 addresses health benefit plan coverage requirements for autism spectrum disorder (ASD) treatments in Texas. The bill ensures that health insurance plans provide adequate coverage for evidence-based autism treatments, likely including behavioral therapies, diagnostic services, and related interventions.

Why is this important

Autism spectrum disorder affects a significant portion of the population, and evidence-based treatments like Applied Behavior Analysis (ABA) can substantially improve outcomes, particularly for children. Insurance coverage gaps create financial barriers that prevent families from accessing these treatments, making this policy relevant to thousands of Texas families managing ASD care costs.

Potential points of contention

  • Coverage scope and cost: Defining which specific treatments must be covered and whether lifetime limits, age restrictions, or visit caps apply could affect both insurance premiums and treatment accessibility
  • Insurance industry impact: Expanded ASD coverage mandates increase insurer costs, potentially raising premiums for all policyholders or leading insurers to limit other benefits
  • Parity with other conditions: Questions about why autism receives specific legislative attention compared to other developmental or behavioral health conditions not explicitly mandated

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

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