April 5, 2010

Hon. William T. Stachowski (sent to all members of the WNY state delegation)
New York State Senate
918 Legislative Office Bldg.
Albany, NY 12247

Dear Senator Stachowski:

On behalf of the 2,500 employer members of the Buffalo Niagara Partnership, I write in opposition to A.10372/S.7000-A, which would require health plans to provide expansive coverage of the diagnosis and treatment of autism spectrum disorders (ASD). Thank you for recognizing that this open-ended insurance coverage mandate will further drive up the cost of health coverage for both individuals and employers by voting “no” in last week’s committee vote on this bill.

Health insurance is a necessity that is becoming increasingly unaffordable for employers. New Yorkers already face sky-rocketing health insurance premiums – statewide, the increase for 2010 was 17%. In addition to the 12.2% already paid to cover the cost of our state’s 51 other health insurance mandates,  the cost of this new coverage to individual policy holders will be anywhere between 2% and 6%.

Moreover, effective since January 2007, New York State insurance law § 3216 already prohibits health plans from excluding coverage for the diagnosis and treatment of ASD. The Partnership agrees that the health plans of families of children diagnosed with ASD should cover medically-necessary costs but this bill requires private insurance to offer expanded treatment including services deemed “educational” in nature – opening up a dangerous and costly loophole that will require private insurers to cover expenses that are not medically-relevant. The legislation also fails to include an age or maximum annual benefit cap on medical expenses associated with the treatment of ASD further driving up premiums; under current state insurance law, this broadly written insurance coverage mandate would cover individuals under their parent’s plans up to the age of 29.

Beyond increasing the cost of health coverage for individuals and employers, the $100 million subsidy pool that was established in 2006 for the sole purpose of helping small businesses offset the cost of this mandate is slowly being eroded. The legislature voted to reduce the subsidy to $80 million last November and now A.10372/S.7000-A proposes an additional $30 million cut, leaving New York’s employers stranded with a subsidy pool that holds half of the necessary funds needed to help businesses survive our state’s 52nd insurance mandate. 

In addition, appointments to the “New York State Health Care Quality & Cost Containment Commission” should be undertaken immediately so that the Commission, established in 2007, can serve its intended purpose – namely, to investigate the potential premium impact of proposed mandated benefits, such as A.10372/S.7000-A and work to ensure the best interest of health care consumers, the small business community, medical community and health plan providers.